Association Between Three-Dimensional Left Ventricular Outflow Tract Area and Gradients After Myectomy in Hypertrophic Obstructive Cardiomyopathy

Determine whether the intraoperative three-dimensional left ventricular outflow tract cross-sectional area may be inversely correlated with pressure gradients as a determinant of surgical success after septal myectomy in hypertrophic cardiomyopathy patients. Perioperative data were obtained by retro...

Full description

Saved in:
Bibliographic Details
Published in:Journal of cardiothoracic and vascular anesthesia 2021-06, Vol.35 (6), p.1654-1662
Main Authors: Moreno Garijo, J., Amador, Y., Fan, C.S., Silverton, N., Ralph-Edwards, A., Woo, A., Mashari, A., Meineri, M.
Format: Article
Language:English
Subjects:
Canada
Cardiomyopathy, Hypertrophic - diagnostic imaging
Cardiomyopathy, Hypertrophic - surgery
Echocardiography, Transesophageal
Humans
hypertrophic cardiomyopathy
intraoperative transesophageal echocardiography
left ventricular hypertrophy
left ventricular outflow obstruction
Mitral Valve Insufficiency
Retrospective Studies
three-dimensional echocardiography
Treatment Outcome
Ventricular Outflow Obstruction - diagnostic imaging
Ventricular Outflow Obstruction - surgery
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Determine whether the intraoperative three-dimensional left ventricular outflow tract cross-sectional area may be inversely correlated with pressure gradients as a determinant of surgical success after septal myectomy in hypertrophic cardiomyopathy patients. Perioperative data were obtained by retrospective review. Toronto General Hospital, University of Toronto, Toronto, Canada, a tertiary hospital. The study comprised 67 patients with hypertrophic obstructive cardiomyopathy. Transthoracic and intraoperative transesophageal echocardiographic assessment of pressure gradients. Transesophageal measurement of the three-dimensional left ventricular outflow tract cross-sectional area. The smallest left ventricular outflow tract area increased on average 1.883 cm2 (98.3%) after septal myectomy. There was a significant correlation between the increase in the area and the transesophageal pressure gradients (r = –0.32; p = 0.01) after myectomy, but none with postoperative transthoracic gradients at rest (r = –0.10; p = 0.42). Postoperative transesophageal and transthoracic gradients were significantly correlated (r = 0.26; p = 0.04). The best risk factors to predict high residual gradients were preoperative transesophageal gradient >97 mmHg, postoperative transesophageal area
ISSN:1053-0770
1532-8422
DOI:10.1053/j.jvca.2020.12.014