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Transaortic Partial Septectomy Through The Right Anterior Minithoracotomy
Oleksandr Babliak;
Diagnostic and Treatment Center For Children And Adults Of The Dobrobut Medical Network, Kyiv, Ukraine
BACKGROUND: To demonstrate the technique of partial septectomy for hyperthrophic obstructive cardiomyopathy through the right anterior minithoracotomy approach.
METHODS: 67 years old woman was presented with shortness of breath on exertion, NYHA II class. Echocardiography showed peak gradient at LVOT of 110 mmHg and mean - of 44 mmHg. The main obstruction was started and the level of papillary muscles and the peak of obstruction was identified at 3 cm distance from the aortic valve. Surgery was performed through the 2nd right intercostal space with cardiopulmonary bypass, transthoracic cross-clamp and blood cardioplegia using long-shafted instruments and the exposure maneuvers shown in the video.
The procedure was recorded by a 10 mm camera inserted through the separate port in the second intercostal space and by overhead camera.
RESULTS: Smooth postoperative course with 5 hours of ventilation, 1 days ICU stay and 8 total postoperative hospital stay was achieved. Intraoperative and predischarged echocardiography showed peak gradient at LVOT of less than 10 mmHg.
CONCLUSIONS: A partial septectomy for hypertrophic obstructive cardiomyopathy can technically be done through the right anterior minithoracotomy that has become our first-choice approach for those patients.
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