Key result
Mitral valve replacement was required in 7.0% of patients with obstructive hypertrophic cardiomyopathy undergoing surgical correction, due to organic lesions or ineffective primary septal myectomy.
Why the study?
The study was conducted to analyze the incidence and causes of mitral valve replacement in patients with obstructive hypertrophic cardiomyopathy.
What is the incidence and cause of mitral valve replacement during surgical correction of obstructive hypertrophic cardiomyopathy?
Observational (n=172)
What is the incidence and cause of mitral valve replacement during surgical correction of obstructive hypertrophic cardiomyopathy?
Mitral valve replacement is required in a small minority (7%) of patients undergoing surgical correction for obstructive HCM, typically due to organic valve lesions or ineffective primary myectomy.
Observational series on MVR incidence in obstructive HCM should not change practice; leaves open predictors of replacement versus repair.
OBJECTIVE: To analyze the incidence and causes of mitral valve replacement in patients with obstructive hypertrophic cardiomyopathy (HCM). MATERIAL AND METHODS: There were 172 patients (98 women and 74 men) with obstructive HCM and severe mitral valve insufficiency between November 2017 and May 2023. All patients complained of chronic heart failure NYHA class III. Surgical correction of left ventricular outflow tract (LVOT) obstruction and mitral valve repair with elimination of systolic anterior motion were technically successful in 160 (93.0%) patients. RESULTS: The need for mitral valve replacement was noted in 12 (7.0%) patients. Mean cardiopulmonary bypass time was 83.5±19.2 min (94; 127), aortic cross-clamping - 62.8±14.3 min (70; 102). In 5 cases, primary mitral valve replacement was scheduled due to obvious organic lesion of the mitral valve (tearing of chords, rheumatic lesion with leaflet restriction). In 7 patients, valve replacement was forced after ineffective primary septal myectomy (LVOT pressure gradient, severe mitral insufficiency). CONCLUSION: Mitral valve replacement is an involuntary strategy after ineffective myectomy with severe mitral insufficiency and high LVOT pressure gradient.
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Lysenko et al. (2023) conducted an observational in Obstructive hypertrophic cardiomyopathy (n=172). Surgical correction of left ventricular outflow tract obstruction and mitral valve repair was evaluated on Incidence of mitral valve replacement. Mitral valve replacement was required in 7.0% of patients with obstructive hypertrophic cardiomyopathy undergoing surgical correction, due to organic lesions or ineffective primary septal myectomy.
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