Clinical & Experimental Cardiology
Open Access
ISSN: 2155-9880
+44 1300 500008
ISSN: 2155-9880
+44 1300 500008
Samer Kassem
Centro Cardiologico Monzino, Italy
Scientific Tracks Abstracts: J Clin Exp Cardiolog
Introduction: The systolic anterior motion (SAM) of mitral valve (MV) associated with the asymmetric hypertrophy of left ventricular septum are the two components responsible for left ventricular outflow obstruction (LVOTO) in hypertrophic obstructive cardiomyopathy (HOCM). The transaortic left ventricular septal myectomy has been proposed as the gold standard surgical procedure for symptomatic patients with severe HOCM since the late 1960s. Objective: We have previously described one technique to prevent SAM post MV repair, the so-called â??paradoxical artificial cords to prevent SAM after MV repairâ?. The aim of this article is to demonstrate the efficacy of this technique also to treat SAM in HOCM patients, in case of concomitant moderate septal myectomy. Methods: The subjects of the study are 5 patients with both SAM and LVOTO. All of them have been surgically treated, performing moderate transaortic septal myomectomy and correction of SAM by paradoxical artificial cords and ring annuloplasty. Results: The postoperative course of all patients was regular. None of them developed the usual complications of this surgery (ventricular septal defect (VSD) or pacemaker (PM) implantation). Transthoracic echocardiography (TTE) has demonstrated good result of the early postoperative inter-ventricular gradient. The MV function was preserved and free of SAM. Conclusion: The paradoxical artificial cords technique could be considered as a valid treatment for SAM in patients with HOCM and LVOTO, if associated with moderate septal myectomy. The combination of these two surgical procedures is particularly important to avoid complications, especially VSD, in patients with a relatively thin inter-ventricular septum, even in presence of hypertrophy
Samer Kassem is a Cardiac Surgeon who works at Centro Cardiologico Monzino in Milan, Italy. His working experience began with general surgery. Since 2004, he stably operates at Centro Cardiologico Monzino, where he found the excellence in cardiac surgery and most of all, the opportunity to develop new personal surgical techniques in different fields.