• Title/Summary/Keyword: Myectomy

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Minimally Invasive Trans-Mitral Septal Myectomy to Treat Hypertrophic Obstructive Cardiomyopathy

  • Kim, Hong Rae;Yoo, Jae Suk;Lee, Jae Won
    • Journal of Chest Surgery
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    • v.48 no.6
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    • pp.419-421
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    • 2015
  • A 43-year-old man with symptomatic hypertrophic obstructive cardiomyopathy (HOCM) was admitted to our hospital with aggravated exertional dyspnea and successfully treated with robotic transmitral septal myectomy. Minimally invasive transmitral septal myectomy may be a feasible surgical option for the treatment of HOCM in selected cases as an alternative to transaortic myectomy.

Tips for Successful Septal Myectomy in Patients with Hypertrophic Cardiomyopathy

  • Kim, Jae Hyun
    • Journal of Chest Surgery
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    • v.51 no.3
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    • pp.227-230
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    • 2018
  • Septal myectomy is the gold-standard treatment of hypertrophic cardiomyopathy. However, it involves the risk of incomplete resection of septal muscles or iatrogenic septal perforation depending on the surgeon's practice. Herein, we suggest a few tips for successful septal myectomy and present a relevant case.

Diagnosis and surgical management of cricopharyngeal achalasia in a dog (개에서의 윤상인두근 이완불능증의 진단 및 수술적 치료 1예)

  • Choi, Hojung;Jeong, Seong Mok
    • Korean Journal of Veterinary Research
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    • v.46 no.1
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    • pp.57-61
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    • 2006
  • A 3-month-old, 2.8 kg, female Cocker spaniel was presented with chronic history of dysphagia since weaning. Video fluoroscopic examination revealed swallowing problems in the upper esophageal sphincters. It was diagnosed as cricopharyngeal achalasia. Cricopharyngeal and thyropharyngeal myectomy was performed. One day after surgical management, normal swallowing movement was observed in the video fluoroscopic examination of the dog. There was no evidence of recurrence for 15 months.

Subtotal Myectomy for Recurrent Cricopharyngeal Dysphagia in a Dog

  • Hong, Sung-jin;Park, Sung-guon;Kim, Sang-yeoun;Moon, Hee-sup;Park, Wan-sang;Kim, Jun-su;Kang, Sung-hun;Lee, Jae-hoon
    • Journal of Veterinary Clinics
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    • v.34 no.4
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    • pp.291-294
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    • 2017
  • An 8-month-old Chow-Chow dog presented with dysphagia and regurgitation, and was diagnosed with cricopharyngeal dysphagia (CPD). Cricopharyngeal myotomy did not improve the clinical signs. Three months after the initial surgery, a subtotal myectomy of cricopharyngeal muscle with partial thyropharngeal myotomy was performed. The clinical improvement was maintained for more than one year after the second surgery. Subtotal myectomy of cricopharyngeal muscle can be considered for dogs with CPD that do not respond to myotomy.

Idiopathic Hypertropic Subaortic Stenosis with Mitral Regurgitation -Report of 3 Cases- (특발성 비후성 대동맥판하 협착증 및 승모판 폐쇄부전증 -3례 보고-)

  • 강청희
    • Journal of Chest Surgery
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    • v.27 no.4
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    • pp.313-317
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    • 1994
  • Surgical treatment is possible for the obstructive form of hypertrophic cardiomyopathy and transaortic left ventricular septal myectomy and myotomy has been the procedure of choice. If coexisting intrinsic mitral valve disease exists, mitral valve replacement has been performed. But abnormal systolic anterior motion of anterior mitral leaflet[SAM] with intrinsic normal mitral valve disease is the typical feature of IHSS and we prefer not to replace mitral valve. 3 patients underwent transaortic myotomy and myectomy for IHSS with mitral regurgitation. 2 patients of them have coexisting intrinsic mitral valve diseases such as mitral valve vegetation and chorda rupture. Concomittent mitral valve replacement were performed. 1 patient shows SAM of mitral anterior leaflet but has intrinsic normal mitral valve morphologically and transepicardial echocardiogram and direct monitoring of pressure gradient during the operative procedure gives better information for subsided mitral regurgitation. Post operative course during the 12 months follow-up was uneventful.

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Extended Septal Myectomy for Hypertrophic Obstructive Cardiomyopathy -Report of a case- (비후형 심근증 환아에서 시행한 광범위 중격절제술 - 1예 보고 -)

  • Lee Jae-Hang;Kwak Jae-Gun;Jung Eui-Suk;Oh Se-Jin;Chang Myoung-Woo;Kim Woong-Han
    • Journal of Chest Surgery
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    • v.39 no.10 s.267
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    • pp.775-778
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    • 2006
  • Hypertrophic cardiomyopathy is characterized by inappropriate hypertrophy of the myocardium and is associated with various clinical presentations ranging from complete absence of symptoms to sudden, unexpected death. These are caused by dynamic obstruction of the left ventricular outflow tract and surgical approaches were initiated. But, the complete resection of hypertrophied midventricular septum is impossible by standard, transaortic approach, because of narrow vision and limited approach. And it leads to inadequate excision, will leave residual left ventricular out-flow tract obstruction or systolic anterior motion of mitral leaflet, and limit symptomatic improvement and patient's survival. We report a case of extended septal myectomy for hypertrophic cardiomyopathy of mid-septum in a child. The extended septal myectomy was performed by aortotomy and left ventricular apical incision, and made possible the complete resection of mid-ventricular septum, abnormal papillary muscles and chordae. The patient's symptom was improved and the postoperative course was uneventful.

Left Ventricular Enlargement Procedure in a Patient with Diffuse-Type Hypertrophic Cardiomyopathy: A Case Report

  • Han, Dong Youb;Park, Sung Jun;Jung, Sung-Ho
    • Journal of Chest Surgery
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    • v.55 no.2
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    • pp.180-182
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    • 2022
  • Surgical septal myectomy is the preferred treatment option for patients with medically intractable obstructive hypertrophic cardiomyopathy. Extended transaortic septal myectomy is a widely performed surgical procedure for patients with subaortic obstruction. The transapical approach may provide an alternative surgical option in less common phenotypes, such as apical hypertrophy or long-segmental septal hypertrophy. In this report, we describe a case of a procedure performed to achieve left ventricular enlargement procedure using a combined transaortic and transapical dual approach in a patient with diffuse-type hypertrophic cardiomyopathy with apical aneurysm and mid-cavity obstruction.

A Case of Thyroarytenoid Myectomy with Selective Recurrent Laryngeal Nerve Section in Intractable Spasmodic Dysphonia: A Long-Term Follow-Up (난치성 연축성 발성장애 환자에서 갑상피열근 절제술 및 선택적 반회후두신경 절제술 1예: 장기 추적 관찰)

  • Lee, Yun Ji;An, You Young;Park, Ki Nam;Lee, Seung Won
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.31 no.1
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    • pp.35-38
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    • 2020
  • Spasmodic dysphonia is a disease presumed to be a form of focal laryngeal dystonia. The widely used first-line treatment is botulinum toxin injection to the thyroarytenoid muscles. In spite of the effectiveness and safety of this method, it has a temporary effect that lasts only several months, resulting the patients' symptom fluctuating, called 'Botox rollercoaster.' Some surgical techniques had tried, but they had shown several limitations including high rate of recurrence. We tried thyroarytenoid myectomy with selective recurrent laryngeal nerve section in a patient with intractable spasmodic dysphonia. This procedure is an alternative treatment of spasmodic dysphonia to prevent recurrence and improve symptoms. During five years of follow-up, she has shown steady quality voice without any complication. To the best of our knowledgement, this is the longest follow-up case of this operation in South Korea.

A Case of Localized Subaortic Stenosis Associated with Aortic Regurgitation (대동맥판폐쇄부전을 동반한 국소성)

  • 김삼현;서필원
    • Journal of Chest Surgery
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    • v.29 no.7
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    • pp.780-784
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    • 1996
  • The localized form of subaortic stenosis shows a spectrum of pathological lesions varing from dis- crete membrane to a thickened flbromuscular collar. Aortic valve is commonly involved late in the pro- cess resulting in regurgitation. Because of the likelihood o the progressive obstruction and aortic regurgitation, early elective oper- ation should be considered for the patient with subaortic stenosis. We experienced a case of localized fibromuscular subaortic stenosis associated with aortic regurgi- tation. Excision of the fibromuscular ridge and septal myectomy-myotomy relieved the subaortic seen- osis. Regurgitant aortic valve was repaired by peeling away the Hbrotic tissue on the cusps and subcommissural annuloplasty at the each commissural area. On postoperative echocardiographic examination, the systolic pressure gradient between left ventricle and aorta decreased markedly and the aortic regurgitation was not detected at all.

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Novel Resectable Myocardial Model Using Hybrid Three-Dimensional Printing and Silicone Molding for Mock Myectomy for Apical Hypertrophic Cardiomyopathy

  • Wooil Kim;Minje Lim;You Joung Jang;Hyun Jung Koo;Joon-Won Kang;Sung-Ho Jung;Dong Hyun Yang
    • Korean Journal of Radiology
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    • v.22 no.7
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    • pp.1054-1065
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    • 2021
  • Objective: We implemented a novel resectable myocardial model for mock myectomy using a hybrid method of three-dimensional (3D) printing and silicone molding for patients with apical hypertrophic cardiomyopathy (ApHCM). Materials and Methods: From January 2019 through May 2020, 3D models from three patients with ApHCM were generated using the end-diastolic cardiac CT phase image. After computer-aided designing of measures to prevent structural deformation during silicone injection into molding, 3D printing was performed to reproduce anatomic details and molds for the left ventricular (LV) myocardial mass. We compared the myocardial thickness of each cardiac segment and the LV myocardial mass and cavity volumes between the myocardial model images and cardiac CT images. The surgeon performed mock surgery, and we compared the volume and weight of the resected silicone and myocardium. Results: During the mock surgery, the surgeon could determine an ideal site for the incision and the optimal extent of myocardial resection. The mean differences in the measured myocardial thickness of the model (0.3, 1.0, 6.9, and 7.3 mm in the basal, midventricular, apical segments, and apex, respectively) and volume of the LV myocardial mass and chamber (36.9 mL and 14.8 mL, 2.9 mL and -9.4 mL, and 6.0 mL and -3.0 mL in basal, mid-ventricular and apical segments, respectively) were consistent with cardiac CT. The volume and weight of the resected silicone were similar to those of the resected myocardium (6 mL [6.2 g] of silicone and 5 mL [5.3 g] of the myocardium in patient 2; 12 mL [12.5 g] of silicone and 11.2 mL [11.8 g] of the myocardium in patient 3). Conclusion: Our 3D model created using hybrid 3D printing and silicone molding may be useful for determining the extent of surgery and planning surgery guided by a rehearsal platform for ApHCM.