Nihan Kayalar, MD, Hartzell V. Schaff, MD, Richard C

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Presentation transcript:

Concomitant Septal Myectomy at the Time of Aortic Valve Replacement for Severe Aortic Stenosis Nihan Kayalar, MD, Hartzell V. Schaff, MD, Richard C. Daly, MD, Joseph A. Dearani, MD, Soon J. Park, MD The Annals of Thoracic Surgery Volume 89, Issue 2, Pages 459-464 (February 2010) DOI: 10.1016/j.athoracsur.2009.10.065 Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Patient with aortic stenosis, septal wall thickening, and significant outflow tract gradient. (A) Transthoracic echocardiography, apical long-axis view: acceleration of flow begins at mid ventricle (small arrows), adjacent to thickened septal wall (star). The aortic valve is denoted by thick arrow. (B) Continuous-wave Doppler (CW) through the outflow tract and aortic valve: the signal shows two different flow accelerations, one late-peaking, dynamic, in the mid ventricle (small arrows), and the other late peaking through the aortic valve (long arrow). (Ao = aorta; LA = left atrium; LV = left ventricle.) The Annals of Thoracic Surgery 2010 89, 459-464DOI: (10.1016/j.athoracsur.2009.10.065) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Another patient with aortic stenosis without outflow tract obstruction. (A) Transthoracic echocardiography, apical long-axis view: acceleration of flow begins just before the aortic valve (small arrows). The septum is not thickened (star). The aortic valve is denoted by thick arrow. (B) Continuous wave Doppler (CW) through the outflow tract and aortic valve: the signal shows the characteristic late-peaking flow acceleration of severe aortic stenosis (long arrow). The weak minimal flow acceleration in the outflow tract is denoted by the small arrows. (Ao = aorta; LA = left atrium; LV = left ventricle.) The Annals of Thoracic Surgery 2010 89, 459-464DOI: (10.1016/j.athoracsur.2009.10.065) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Survival curve of patients. The Annals of Thoracic Surgery 2010 89, 459-464DOI: (10.1016/j.athoracsur.2009.10.065) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions