First-in-Human Transapical Beating-Heart Septal Myectomy in Patients With Hypertrophic Obstructive Cardiomyopathy

To simplify surgical septal reduction therapy for hypertrophic obstructive cardiomyopathy (HOCM), we developed a novel transapical beating-heart septal myectomy (TA-BSM) procedure. In this study, we sought to evaluate the clinical utility of TA-BSM in a first-in-human trial. Patients with HOCM were...

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Bibliographic Details
Published in:Journal of the American College of Cardiology 2023-08, Vol.82 (7), p.575-586
Main Authors: Fang, Jing, Liu, Yani, Zhu, Ying, Li, Rui, Wang, Rui, Wang, Dao Wen, Song, Yunhu, Li, Chenhe, Chen, Yue, Cheng, Lin, Zheng, Kangchao, Zhao, Yun, Li, Shiliang, Cheng, Cai, Xia, Liming, Chen, Xiaoping, Wan, Song, Wei, Xiang
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Cardiomyopathy, Hypertrophic - complications
Cardiomyopathy, Hypertrophic - surgery
Child
Coronary Artery Bypass
Echocardiography
Female
Heart Septum - diagnostic imaging
Heart Septum - surgery
Humans
Male
Middle Aged
Mitral Valve Insufficiency - surgery
Treatment Outcome
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Summary:To simplify surgical septal reduction therapy for hypertrophic obstructive cardiomyopathy (HOCM), we developed a novel transapical beating-heart septal myectomy (TA-BSM) procedure. In this study, we sought to evaluate the clinical utility of TA-BSM in a first-in-human trial. Patients with HOCM were enrolled if they presented with drug-refractory disabling symptoms. TA-BSM was performed via minithoracotomy with the use of our beating-heart myectomy device under echocardiographic guidance, without the use of cardiopulmonary bypass. Repeated resections were performed to tailor the extent of the septal myectomy for sufficient abolishment of left ventricular outflow tract (LVOT) obstruction and mitral regurgitation (MR). The primary outcome measure was procedural success, defined by resting/provoked LVOT gradient 
ISSN:0735-1097
1558-3597
DOI:10.1016/j.jacc.2023.05.052