Abstract:
BACKGROUND:Incidence and outcome of mitral valve (MV) surgery are unknown in patients with hypertrophic obstructive cardiomyopathy (HOCM) undergoing extended transaortic septal myectomy. OBJECTIVES:This study sought to define indications and suitable operative strategy for mitral regurgitation (MR) in patients with HOCM. METHODS:A total of 2,107 septal myectomy operations performed in adults from January 1993 to May 2014 at Mayo Clinic in Rochester, Minnesota, were retrospectively reviewed. Patients with prior MV operation and apical hypertrophic cardiomyopathy were excluded. Overall, 2,004 operations were performed in 1,993 patients. RESULTS:Pre-operative MR was grade ≥3 (of 4) in 1,152 operations (57.5%). Systolic anterior motion of mitral leaflets caused the MR in most patients. However, intrinsic MV disease was identified pre-operatively in 99 patients, all of whom had MV surgery (with septal myectomy). In 1,905 operations, no intrinsic MV disease was identified pre-operatively; in 1,830 (96.1%), septal myectomy was performed without a direct MV procedure. For 75 patients, intrinsic MV disease discovered intraoperatively led to concomitant MV repair (86.7%) or replacement (13.3%). After isolated septal myectomy, the percentage of patients with MR grade ≥3 decreased from 54.3% to 1.7% (p = 0.001) on early post-operative echocardiography. Among 174 patients with concomitant MV surgery, late survival was superior with MV repair (n = 133 [76.4%]) versus replacement (10-year survival: 80.0% vs. 55.2%; p = 0.002). CONCLUSIONS:In most patients with HOCM, MR related to systolic anterior motion of the MV is relieved through adequate myectomy. Concomitant MV surgery is rarely necessary unless intrinsic MV disease is present. When MV procedures are required, repair is preferred because of improved survival compared with replacement.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Hong JH,Schaff HV,Nishimura RA,Abel MD,Dearani JA,Li Z,Ommen SRdoi
10.1016/j.jacc.2016.07.735subject
Has Abstractpub_date
2016-10-04 00:00:00pages
1497-504issue
14eissn
0735-1097issn
1558-3597pii
S0735-1097(16)34751-9journal_volume
68pub_type
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(99)00164-3
更新日期:1999-07-01 00:00:00
abstract:OBJECTIVES:We sought to compare, through a meta-analytic process, the transradial and transfemoral approaches for coronary procedures in terms of clinical and procedural outcomes. BACKGROUND:The radial approach has been increasingly used as an alternative to femoral access. Several trials have compared these two appro...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jacc.2004.04.034
更新日期:2004-07-21 00:00:00
abstract:OBJECTIVES:This study sought to ascertain whether high-dose allopurinol causes regression of left ventricular mass (LVM) in patients with type 2 diabetes mellitus (T2DM). BACKGROUND:Left ventricular hypertrophy (LVH) is common in T2DM and contributes to patients' high cardiovascular (CV) event rate. Oxidative stress (...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jacc.2013.07.074
更新日期:2013-12-17 00:00:00
abstract:OBJECTIVES:We investigated the prevalence of lamin A/C (LMNA) gene defects in familial and sporadic dilated cardiomyopathies (DCM) associated with atrioventricular block (AVB) or increased serum creatine-phosphokinase (sCPK), and the corresponding changes in myocardial and protein expression. BACKGROUND:It has been re...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(02)01724-2
更新日期:2002-03-20 00:00:00
abstract:OBJECTIVES:This study was conducted to assess the need for, and use of, fenestration of an extracardiac conduit Fontan. BACKGROUND:Fenestration of a Fontan connection has been proposed as a means of improving outcomes of single ventricle palliation. The benefit of fenestration is likely to be greatest in the early pos...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(99)00228-4
更新日期:1999-08-01 00:00:00
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doi:10.1016/0735-1097(92)90462-v
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pub_type: 杂志文章,多中心研究
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更新日期:2018-04-24 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(02)02062-4
更新日期:2002-09-04 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2013-10-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,多中心研究
doi:10.1016/s0735-1097(97)00332-x
更新日期:1997-11-15 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
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更新日期:2015-06-30 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2010.11.045
更新日期:2011-04-26 00:00:00
abstract::To test the value of acceleration flow signals proximal to the leaking orifice in assessing the severity of prosthetic mitral valve regurgitation, 39 consecutive patients undergoing left ventriculography were examined by Doppler color flow imaging. Acceleration flow signals proximal to the regurgitant orifice were det...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(92)90487-8
更新日期:1992-02-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2004.11.053
更新日期:2005-03-15 00:00:00
abstract::Lorcainide, a new antiarrhythmic agent with local anesthetic or membrane-stabilizing properties similar to those of quinidine, was tested in 76 patients with diverse types of heart disease and recurrent ventricular tachycardia or ventricular fibrillation. Lorcainide was administered for 72 to 96 hours in a dose rangin...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(84)80293-4
更新日期:1984-06-01 00:00:00
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pub_type: 杂志文章
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更新日期:2018-07-17 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2006.05.080
更新日期:2006-12-19 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,随机对照试验
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doi:10.1016/s0735-1097(98)00469-0
更新日期:1998-12-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(93)90667-p
更新日期:1993-02-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,meta分析
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更新日期:1995-08-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1993-05-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
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更新日期:2010-01-26 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,多中心研究
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更新日期:2008-12-16 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
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更新日期:1998-01-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(95)00324-X
更新日期:1995-11-01 00:00:00
abstract:BACKGROUND:Patients with severe aortic stenosis (AS) who were deemed too high risk or inoperable for conventional aortic valve replacement (AVR) in the PARTNER (Placement of Aortic Transcatheter Valves) trial were randomized to transcatheter aortic valve replacement (TAVR) versus AVR (PARTNER-A arm) or standard therapy...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jacc.2013.08.1666
更新日期:2014-07-15 00:00:00
abstract:OBJECTIVES:This study sought to assess the usefulness and accuracy of artificial neural networks in the prognosis of 1-year mortality in patients with heart failure. BACKGROUND:Artificial neural networks is a computational technique used to represent and process information by means of networks of interconnected proce...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
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更新日期:1995-12-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(95)00574-9
更新日期:1996-04-01 00:00:00