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You are here: Contents > 2015 > Volume 24 Number 1 January 2015 > MISCELLANEOUS > Trans-Septal Approach for Hypertrophic Obstructive Cardiomyopathy

Trans-Septal Approach for Hypertrophic Obstructive Cardiomyopathy

Yasunobu Konishi1, Yu Shomura2, Naoto Fukunaga1, Tadaaki Koyama1, Yukikatsu Okada3

1Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Kobe, 2Department of Cardiovascular Surgery, Anjo Kosei Hospital, Aichi, 3Heart Valve Center, Midori Hospital, Kobe, Japan

Transaortic septal myectomy, known as Morrow’s procedure, is a standard treatment for hypertrophic obstructive cardiomyopathy (HOCM). The case is described of a 58-year-old male patient who suffered a repetition of syncope due to HOCM, in whom septal myectomy was performed. As resection of the hypertrophied septum using Morrow’s procedure was considered insufficient by palpation to release mitral regurgitation (MR) and systolic anterior motion of the mitral valve, the surgical approach was changed such that the right ventricular outflow tract and ventricular septum was incised. The residual hypertrophied septum was successfully resected to the base of the anterior papillary muscle under direct vision. Postoperative echocardiography demonstrated a dramatic improvement in the MR and left ventricular outflow tract obstruction. The patient’s postoperative course was good, with cibenzoline and calcium channel blocker therapy stopped and beta-blocker therapy reduced after surgery. If resection of the hypertrophied septum using Morrow’s procedure is considered insufficient, a trans-septal approach represents an adequate option to treat HOCM.

The Journal of Heart Valve Disease 2015;24:89-91


Trans-Septal Approach for Hypertrophic Obstructive Cardiomyopathy

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