Key result
TEE-guided transapical beating-heart septal myectomy successfully reduces LVOT obstruction without bypass.
Why the study?
A novel surgical approach known as transapical beating-heart septal myectomy was developed for HOCM patients, requiring crucial perioperative anesthesia management.
Does transapical beating-heart septal myectomy reduce left ventricular outflow tract obstruction in patients with hypertrophic obstructive cardiomyopathy?
Case Report (n=3)
No
Does transapical beating-heart septal myectomy reduce left ventricular outflow tract obstruction in patients with hypertrophic obstructive cardiomyopathy?
Transapical beating-heart septal myectomy is a novel, feasible surgical approach that reduces LVOT obstruction in HOCM patients without cardiopulmonary bypass when supported by precise anesthesia and TEE guidance.
Hypothesis-generating for off-pump myectomy in HOCM; larger prospective studies needed before any practice consideration.
Background: Septal myectomy is the gold standard for treating severe hypertrophic obstructive cardiomyopathy (HOCM). Recently, the cardiothoracic surgery team from our hospital has developed a novel surgical approach known as transapical beating-heart septal myectomy (TA-BSM) for HOCM patients. Case presentation: Anesthesia management is crucial in this groundbreaking procedure. We present three representative cases of patients with HOCM: a typical case, a geriatric case, and a case with extreme hypertrophy of the interventricular septum. Additionally, we summarize the perioperative anesthesia management specific to TA-BSM. Conclusions: Guided by transesophageal echocardiography, TA-BSM significantly reduces left ventricular outflow tract obstruction without cardiopulmonary bypass. Precise perioperative anesthesia management, coupled with seamless collaboration among anesthesiologists, surgeons, and sonographers, has been pivotal to the successful implementation of this procedure in HOCM patients.
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Xu et al. (2024) conducted a case report in Hypertrophic obstructive cardiomyopathy (HOCM) (n=3). Transapical beating-heart septal myectomy (TA-BSM) and perioperative anesthesia management was evaluated on Reduction of left ventricular outflow tract obstruction. Transapical beating-heart septal myectomy, guided by transesophageal echocardiography and precise anesthesia management, significantly reduced left ventricular outflow tract obstruction without bypass.
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