Management of the mitral valve in patients with obstructive hypertrophic cardiomyopathy

Joon Hwa Hong, Anita Nguyen, Hartzell V Schaff

Research output: Contribution to journalReview article

Abstract

Septal myectomy is the gold standard treatment option for patients with obstructive hypertrophic cardiomyopathy whose symptoms do not respond to medical therapy. This operation reliably relieves left ventricular outflow tract gradients, systolic anterior motion of the mitral valve, and associated mitral valve regurgitation. However, there remains controversy regarding the necessity of mitral valve intervention at the time of septal myectomy. While some clinicians advocate for concomitant mitral valve procedures, others strongly believe that the mitral valve should only be operated on if there is intrinsic mitral valve disease. At Mayo Clinic, we have performed septal myectomy on more than 3000 patients with obstructive hypertrophic cardiomyopathy, and in our experience, mitral valve operation is rarely necessary for patients who do not have intrinsic mitral valve disease such as leaflet prolapse or severe calcific stenosis. In this paper, we review anatomical considerations, imaging, and surgical approaches in the management of the mitral valve in hypertrophic cardiomyopathy.

Original languageEnglish (US)
JournalIndian Journal of Thoracic and Cardiovascular Surgery
DOIs
StatePublished - Jan 1 2019

Fingerprint

Hypertrophic Cardiomyopathy
Mitral Valve
Prolapse
Mitral Valve Insufficiency
Pathologic Constriction
Therapeutics

Keywords

  • Hypertrophic cardiomyopathy
  • Mitral valve
  • Myectomy

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Management of the mitral valve in patients with obstructive hypertrophic cardiomyopathy. / Hong, Joon Hwa; Nguyen, Anita; Schaff, Hartzell V.

In: Indian Journal of Thoracic and Cardiovascular Surgery, 01.01.2019.

Research output: Contribution to journalReview article

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