The Surgeon’s View of the Left Ventricular Outflow Tract in Congenital Heart Surgery

Author:

Stephens Elizabeth H.1,Dearani Joseph A.1,Johnson Jonathan N.23,Ackerman Michael J.234,Ommen Steve R.3,Schaff Hartzell V.1

Affiliation:

1. Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, USA

2. Department of Pediatric and Adolescent Medicine/Division of Pediatric Cardiology, Mayo Clinic, Rochester, MN, USA

3. Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA

4. Department of Molecular Pharmacology & Experimental Therapeutics/Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, MN, USA

Abstract

Left ventricular outflow tract (LVOT) obstruction is a component of many forms of congenital heart disease, including hypertrophic cardiomyopathy, membranous subaortic stenosis, tunnel subaortic stenosis, and outflow tract obstruction related to atrioventricular septal defects. We have gained a particularly extensive experience with the diagnosis and treatment of hypertrophic cardiomyopathy, having performed septal myectomy in over 3,800 patients. In the setting of this review of LVOT obstruction, we use hypertrophic cardiomyopathy as a template by which other pathologies causing LVOT obstruction can be understood. We review important surgical issues in patient selection, diagnostic evaluation, interpretation of imaging, and operative management. To this end, the review focuses on obstructive hypertrophic cardiomyopathy and then broadens to discuss other pathologies causing LVOT obstruction, with important similarities and differences in their management. These other pathologies share some similar presentations and operative techniques, and at times can be confused with hypertrophic cardiomyopathy, but also have important distinctions of which the surgeon should be aware.

Publisher

SAGE Publications

Subject

Cardiology and Cardiovascular Medicine,General Medicine,Pediatrics, Perinatology, and Child Health,Surgery

Cited by 6 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Hypertrophic Cardiomyopathy:  Preadolescence, Mitral Valve Disease, and Midventricular Obstruction;Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual;2023-12

2. Septal Myectomy Outcomes in Children and Adolescents With Obstructive Hypertrophic Cardiomyopathy;The Annals of Thoracic Surgery;2023-09

3. Impact of Genetic Disorders in the Surgical Management of Congenital Heart Disease;World Journal for Pediatric and Congenital Heart Surgery;2023-03

4. Subaortic Stenosis in Adult Patients With Atrioventricular Septal Defect;The Annals of Thoracic Surgery;2023-02

5. Step G for Gradients in Stress Echocardiography;Stress Echocardiography;2023

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