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Endoscopic Transmitral Treatment of HOCM

Monday, January 18, 2016

HOCM with a high intracavitary gradient is a challenging operation. The endoscopic transmitral approach provides the surgeon with better visualization of the hypertrophic muscle to be resected. This results in a better postoperative result, both in terms of relief and the minimally invasive aspect of the intervention.


This is a very nice innovative technique and a well done surgery. I just did open transmitral septal myectomy in a 61-years old lady; and, did appreciate the ease of resecting hyperthropic septal myocardium by endoscopic approach. The point of avoiding intervention on mitral annulus is well taken, to avoid secondary SAM. I did replace the mitral valve in my patient because of anomalous papillary muscle band which impeded mitral valve coaptation; hence, demanded extensive resection inclusive the adhesive anomalous bands to the anterior mitral valve leaflet. I shall admit that HOCM presents with numerous variation such the one encountered in my case. In all, congratulation to the team in Switzerland.
Probably one of the best versions I've seen implemented this approach. I congratulate his team much. I had the opportunity to train with Dr. Salvador in Vicenza, who also develops this technique, unlike you generally has placed an incomplete support ring as mitral plasty. again congratulations to your team.

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