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Myectomy and Mitral Valve Repair for Hypertrophic Cardiomyopathy With an Explanation of the Physiology
Gaudiani V, Tsau P. Myectomy and Mitral Valve Repair for Hypertrophic Cardiomyopathy With an Explanation of the Physiology. October 2024. doi:10.25373/ctsnet.27270348
This video demonstrates a myectomy for hypertrophic cardiomyopathy in a 70-year-old woman with a 100-mmHg gradient in her LVOT.
The right femoral vein was cannulated, followed by the aorta, then a RSPV vent was placed and cardioplegia was administered. When the aorta was opened, an aberrant papillary muscle was immediately observed pulling the anterior leaflet forward toward the hypertrophic muscle. A scar was also visible on the septum where the anterior leaflet hits the septum in this condition.
An incision was made into the septum, and the exact length and width of the excision are explained in the video. Then, the roof of the left atrium was opened to access the mitral valve, and 2.0 Dacron sutures were used to pull the posterior leaflet backward to alter the position of the coaptation to a more posterior position. An annuloplasty ring was then placed, and the operation was completed.
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