Thoracoscopic Trans-mitral Septal Myectomy for Hypertrophic Obstructive Cardiomyopathy in the Elderly Article Swipe
Peijian Wei
,
Jian Liu
,
Jiexu Ma
,
Yanjun Liu
,
Tong Tan
,
Hongxiang Wu
,
Wei Zhu
,
Zhao Chen
,
Jimei Chen
,
Jian Zhuang
,
Huiming Guo
·
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.3389/fcvm.2022.827860
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.3389/fcvm.2022.827860
Background The thoracoscopic trans-mitral approach can not only facilitate exposure of the ventricular septum, mitral valve, and subvalvular apparatus, it also enables the surgeons to perform concomitant mitral valve intervention. This study aimed to determine the safety and efficacy of thoracoscopic trans-mitral septal myectomy in elderly patients with hypertrophic obstructive cardiomyopathy (HOCM). Methods We reviewed the demographic to clinical characteristics and outcomes of patients who underwent thoracoscopic trans-mitral septal myectomy in our center between April 2019 and April 2021. The population was divided into a younger group (<60 years) and an elderly group (≥60 years). Results There were 46 and 20 patients in the younger and elderly groups, respectively. The majority of patients in the elderly group were female (39.1 vs. 80.0%, P < 0.01). Patients in the elderly group were more likely to be in New York Heart Association Class IV (2.2 vs. 80.0%, P < 0.01). The European System for Cardiac Operation Risk Evaluation II predicted mortality rates were significantly higher (3.97 ± 1.81 vs. 1.62 ± 0.86%, P < 0.01) in the elderly group. In the elderly group, a patient converted to median sternotomy due to left ventricular posterior free wall rupture following septal myectomy and mitral bioprosthetic valve replacement. The patient then underwent double-patch sandwich repair for rupture and mitral mechanical valve replacement and was eventually discharged. All patients in the elderly group were discharged, while one in the younger group died. No patient in the elderly group required permanent pacemaker implantation vs. one in the younger group. Patients in the elderly group were more likely to spend more time in the intensive care unit than those in the younger group (5.44 ± 5.80 days vs. 3.07 ± 2.72, P < 0.05). However, there was no significant intergroup difference in in-hospital mortality or complications. Importantly, the left ventricular outflow tract pressure gradient was significantly decreased from 96.15 ± 32.89 mmHg to 8.2 ± 3.42 mmHg with no residual obstruction in the elderly group. The interventricular septal thickness was significantly decreased from 19.73 ± 3.14 mm to 11.30 ± 2.23 mm. Postoperative mitral regurgitation severity was significantly improved in the elderly group. Conclusion This study demonstrated that thoracoscopic trans-mitral septal myectomy is a feasible option for selected elderly patients with satisfactory outcomes similar to those of young patients.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.3389/fcvm.2022.827860
- https://www.frontiersin.org/articles/10.3389/fcvm.2022.827860/pdf
- OA Status
- gold
- Cited By
- 6
- References
- 22
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4220667810
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W4220667810Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.3389/fcvm.2022.827860Digital Object Identifier
- Title
-
Thoracoscopic Trans-mitral Septal Myectomy for Hypertrophic Obstructive Cardiomyopathy in the ElderlyWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2022Year of publication
- Publication date
-
2022-03-09Full publication date if available
- Authors
-
Peijian Wei, Jian Liu, Jiexu Ma, Yanjun Liu, Tong Tan, Hongxiang Wu, Wei Zhu, Zhao Chen, Jimei Chen, Jian Zhuang, Huiming GuoList of authors in order
- Landing page
-
https://doi.org/10.3389/fcvm.2022.827860Publisher landing page
- PDF URL
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https://www.frontiersin.org/articles/10.3389/fcvm.2022.827860/pdfDirect link to full text PDF
- Open access
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YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
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https://www.frontiersin.org/articles/10.3389/fcvm.2022.827860/pdfDirect OA link when available
- Concepts
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Medicine, Septal myectomy, Mitral valve replacement, Cardiology, Mitral valve, Internal medicine, Hypertrophic cardiomyopathy, Concomitant, Mitral valve repair, Surgery, Cardiac surgery, Cardiomyopathy, Heart failure, Obstructive cardiomyopathyTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
6Total citation count in OpenAlex
- Citations by year (recent)
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2025: 3, 2024: 1, 2023: 2Per-year citation counts (last 5 years)
- References (count)
-
22Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.demographic | 56 |
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| corresponding_author_ids | https://openalex.org/A5001453728 |
| countries_distinct_count | 1 |
| institutions_distinct_count | 11 |
| corresponding_institution_ids | https://openalex.org/I4210145693, https://openalex.org/I4210153930 |
| sustainable_development_goals[0].id | https://metadata.un.org/sdg/3 |
| sustainable_development_goals[0].score | 0.8999999761581421 |
| sustainable_development_goals[0].display_name | Good health and well-being |
| citation_normalized_percentile.value | 0.79330925 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | False |