Application of cryoenergy to improve septal exposure during transaortic septal myectomy in hypertrophic obstructive cardiomyopathy
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For the past few decades, the transaortic septal myectomy (Morrow’s procedure) has been the gold standard for treating severe left ventricular outflow tract obstruction in hypertrophic obstructive cardiomyopathy (HOCM) patients. 30-day mortality has been reported at less than 1% in dedicated centers. However, in a subgroup of patients, the interventricular septal obstruction is localized very distally, below the aortic valve plane, and the transaortic approach can be very challenging. A subset of these patients can present with residual obstruction after surgery, due to inadequate length of septal excision, leading to reoperation. The aim of this work is to illustrate an original application of cryoenergy to improve the transaortic exposure of the interventricular septum and thus enable surgeons to perform very distal myectomies in HOCM patients.
KeywordsHypertrophic cardiomyopathy Cryoenergy Transaortic myectomy Residual left ventricular outflow tract obstruction
Compliance with ethical standards
Conflict of interest
Alberto Pozzoli reports no conflict of interest; Luca Vicentini reports no conflict of interest; Stefan Thelin reports no conflict of interest; Elisabetta Lapenna reports no conflict of interest; Leif Nilsson reports no conflict of interest; Ottavio Alfieri reports no conflict of interest.
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