{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T20:48:37Z","timestamp":1748983717143},"reference-count":21,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thorac Cardiovasc Surg"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Transmitral myectomy for symptomatic hypertrophic obstructive cardiomyopathy is possible with existence of substantial mitral valve disease. We present herein our experience of minimally invasive transmitral septal myectomy combined with mitral valve surgery through right anterior mini-thoracotomy in the past 4 years at our institution.<\/jats:p><jats:p>\n          Methods\u2003Between March 2017 and October 2020, 14 patients with hypertrophic obstructive cardiomyopathy and mitral valve disease required minimally invasive transmitral septal myectomy combined with mitral valve reconstruction or replacement at our institution. Mean age of patients was 54.2\u2009\u00b1\u200911.4 and 42.9% (n\u2009=\u20096) were female. Twelve patients (85.1%) were in New York Heart Association class III to IV and 6 patients (42.9%) presented with persistent atrial fibrillation. Clinical data were prospectively entered into our institutional database.<\/jats:p><jats:p>\n          Results\u2003Cardiopulmonary bypass time accounted for 140.2\u2009\u00b1\u200932.6\u2009minutes and the myocardial ischemic time was 78.5\u2009\u00b1\u200912.4\u2009minutes. Thirty-day mortality and overall mortality were zero. Peak ventricular outflow gradient decreased from 75.2\u2009\u00b1\u200912.7 to 9.4\u2009\u00b1\u20092.3\u2009mm Hg (p\u2009&lt;\u20090.0001). Simultaneously, mitral valve reconstruction and replacement were performed in 11 (78.6%) and 3 (21.4%) patients, respectively. No systolic anterior motion was seen in patients with mitral valve repair. No conversion to full sternotomy and\/or rethoracotomy was noted. During a mean follow-up period of 24\u2009\u00b1\u200913 months, no patient required reoperation, no recurrence mitral regurgitation, and left ventricular outflow tract obstruction.<\/jats:p><jats:p>\n          Conclusion\u2003Transmitral septal myectomy combined with mitral valve surgery through right anterior mini-thoracotomy can be performed safely with excellent surgical outcomes.<\/jats:p>","DOI":"10.1055\/s-0042-1744261","type":"journal-article","created":{"date-parts":[[2022,5,29]],"date-time":"2022-05-29T22:32:00Z","timestamp":1653863520000},"page":"171-177","source":"Crossref","is-referenced-by-count":6,"title":["Transmitral Septal Myectomy and Mitral Valve Surgery via Right Mini-Thoracotomy"],"prefix":"10.1055","volume":"71","author":[{"given":"Ali","family":"El-Sayed Ahmad","sequence":"additional","affiliation":[{"name":"Division of Thoracic and Cardiovascular Surgery, HELIOS Klinikum Siegburg, Siegburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saad","family":"Salamate","sequence":"additional","affiliation":[{"name":"Division of Thoracic and Cardiovascular Surgery, HELIOS Klinikum Siegburg, Siegburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabrina","family":"Giammarino","sequence":"additional","affiliation":[{"name":"Division of Thoracic and Cardiovascular Surgery, HELIOS Klinikum Siegburg, Siegburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veceslav","family":"Ciobanu","sequence":"additional","affiliation":[{"name":"Division of Thoracic and Cardiovascular Surgery, HELIOS Universit\u00e4tsklinikum Wuppertal, Siegburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farhad","family":"Bakhtiary","sequence":"additional","affiliation":[{"name":"Division of Thoracic and Cardiovascular Surgery, HELIOS Klinikum Siegburg, Siegburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,5,29]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1161\/CIRCULATIONAHA.107.694158","article-title":"Management of symptoms in hypertrophic cardiomyopathy","volume":"117","author":"M A Fifer","year":"2008","journal-title":"Circulation"},{"key":"ref2","first-page":"670","article-title":"Transaortic septal myectomy for obstructive hypertrophic cardiomyopathy","volume":"106","author":"A Nguyen","year":"2018","journal-title":"Oper Tech Thorac Cardiovasc Surg"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"1497","DOI":"10.1016\/j.jacc.2016.07.735","article-title":"Mitral regurgitation in patients with hypertrophic obstructive cardiomyopathy: implications for concomitant valve procedures","volume":"68","author":"J H Hong","year":"2016","journal-title":"J Am Coll Cardiol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.ccl.2018.08.006","article-title":"Surgical myectomy subaortic, midventricular, and apical","volume":"37","author":"A Nguyen","year":"2019","journal-title":"Cardiol Clin"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1007\/s12551-014-0153-3","article-title":"Surgery for hypertrophic cardiomyopathy","volume":"7","author":"J J Wu","year":"2015","journal-title":"Biophys Rev"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1016\/j.ejcts.2008.05.015","article-title":"Minimal invasive mitral valve repair for mitral regurgitation: results of 1339 consecutive patients","volume":"34","author":"J Seeburger","year":"2008","journal-title":"Eur J Cardiothorac Surg"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1016\/j.jacc.2010.03.053","article-title":"Minimally-invasive valve surgery","volume":"56","author":"J D Schmitto","year":"2010","journal-title":"J Am Coll Cardiol"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"1618","DOI":"10.1016\/j.athoracsur.2005.12.006","article-title":"Two hundred forty minimally invasive mitral operations through right minithoracotomy","volume":"81","author":"T Aybek","year":"2006","journal-title":"Ann Thorac Surg"},{"issue":"05","key":"ref9","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1177\/1556984519864939","article-title":"Operative outcomes of concomitant minimally invasive mitral and tricuspid valve surgery","volume":"14","author":"A Kilic","year":"2019","journal-title":"Innovations (Phila)"},{"issue":"02","key":"ref10","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1097\/imi.0000000000000132","article-title":"Minimally invasive septal myectomy for the treatment of hypertrophic obstructive cardiomyopathy and intrinsic mitral valve disease","volume":"10","author":"DSh Gilmanov","year":"2015","journal-title":"Innovations (Phila)"},{"issue":"06","key":"ref11","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1007\/s11748-018-0908-z","article-title":"Minimally invasive trans-mitral septal myectomy for diffuse-type hypertrophic obstructive cardiomyopathy","volume":"66","author":"T Sakaguchi","year":"2018","journal-title":"Gen Thorac Cardiovasc Surg"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1016\/j.jacc.2005.02.090","article-title":"Long-term effects of surgical septal myectomy on survival in patients with obstructive hypertrophic cardiomyopathy","volume":"46","author":"S Ommen","year":"2005","journal-title":"J Am Coll Cardiol"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"2033","DOI":"10.1161\/01.CIR.0000162460.36735.71","article-title":"Clinical and echocardiographic determinants of long- term survival after surgical myectomy in obstructive hypertrophic cardiomyopathy","volume":"111","author":"A Woo","year":"2005","journal-title":"Circulation"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1161\/CIRCULATIONAHA.112.000849","article-title":"Predictors of long-term outcomes in symptomatic hyper- trophic obstructive cardiomyopathy patients undergoing surgical relief of left ventricular outflow tract obstruction","volume":"128","author":"M Desai","year":"2013","journal-title":"Circulation"},{"issue":"01","key":"ref15","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.jjcc.2014.08.010","article-title":"Long-term outcomes of septal reduction for obstructive hypertrophic cardiomyopathy","volume":"66","author":"D Sedehi","year":"2015","journal-title":"J Cardiol"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"1833","DOI":"10.1016\/j.jtcvs.2013.07.024","article-title":"Myectomy and mitral repair through the left atrium in hyper- trophic obstructive cardiomyopathy: the preferred approach for contemporary surgical candidates?","volume":"147","author":"H Gutermann","year":"2014","journal-title":"J Thorac Cardiovasc Surg"},{"key":"ref17","first-page":"729","article-title":"Keynote Lecture-transmitral hypertrophic obstructive cardiomyopathy (HOCM) repair","volume":"2","author":"F W Mohr","year":"2013","journal-title":"Ann Cardiothorac Surg"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1067\/mtc.2002.125644","article-title":"Idiopathic hypertrophic subaortic stenosis can be treated endoscopically","volume":"124","author":"F Casselman","year":"2002","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"02","key":"ref19","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1177\/1556984520977212","article-title":"Video-assisted minimally invasive aortic valve replacement through right anterior minithoracotomy for all comers with aortic valve disease","volume":"16","author":"F Bakhtiary","year":"2021","journal-title":"Innovations (Phila)"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1016\/j.amjcard.2014.12.017","article-title":"Long-term benefit of myectomy and anterior mitral leaflet extension in obstructive hyper- trophic cardiomyopathy","volume":"115","author":"P A Vriesendorp","year":"2015","journal-title":"Am J Cardiol"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"2000","DOI":"10.1016\/j.athoracsur.2013.02.024","article-title":"Late results of mitral valve repair with glutaraldehyde-treated autologous pericardium","volume":"95","author":"Y Shomura","year":"2013","journal-title":"Ann Thorac Surg"}],"container-title":["The Thoracic and Cardiovascular Surgeon"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0042-1744261.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,5]],"date-time":"2023-04-05T23:30:28Z","timestamp":1680737428000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0042-1744261"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,29]]},"references-count":21,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2023,4,5]]},"published-print":{"date-parts":[[2023,4]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0042-1744261","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0171-6425","1439-1902"],"issn-type":[{"value":"0171-6425","type":"print"},{"value":"1439-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,29]]}}}