International Society For Minimally Invasive Cardiothoracic Surgery

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Transmitral Approach For Relief Of Hypertrophic Obstructive Cardiomyopathy
FUMIKAZU NOMURA, Masato Suzuki, Syunsuke Ohori, Kiyotaka Morimoto, Yohei Ohkawa.

Background: Myo-myectomy for HOCM through aortic valve had limitations such as limited operative view, risk of aortic valve damage, and insufficient muscle resection. Method: Via left atrial (trans-mitral) approach can provide an opportunity for mitral valve repair / replacement for mitral regurgitation. Result: 6 patients (6 - 73 years old) had myo-myectomy for diffuse subaortic obstruction of HOCM with our approach. 3 had mitral valve repair and 3 had mitral valve replacement. Every case had relief of obstruction and symptom (LVOT gradient; 5~26mmHg).Conclusion: Our approach could provide wide view of subaortic region and lower portion of the septum and adequate operative view for those with diffuse type of HOCM. Legend: Myo-mectomy for subaortic obstruction through mitral annulus


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