Transapical approach under 3D printing guidance for myectomy in apical hypertrophic cardiomyopathy: A case report_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

TAN Tong ^1,2 , WEI Peijian ^1,2 , LIU Jian ¹ , ZANG Xin ¹ , ZHU Wei ¹ , WU Hongxiang ¹ , LIU Yanjun ¹ , LI Xiaoyi ¹ , ZHUANG Jian ¹ ,  GUO Huiming ¹

1. Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, P. R. China;
2. Shantou University Medical College, Shantou, 515041, Guangdong, P. R. China;

Corresponding author：

GUO Huiming, Email: guohuiming@gdph.org.cn

Keywords：

Hypertrophic cardiomyopathy; ventricular aneurysm; midventricular obstruction; transapical myectomy; case report

DOI：

10.7507/1007-4848.202202003

Video：

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We reported a 26-year-old male who was diagnosed with apical hypertrophic cardiomyopathy with left ventricular aneurysm. The location of the hypertrophic myocardium and the extent of resection were accurately assessed preoperatively using 3D modeling and printing technology. Myectomy was performed via transapical approach, and the intraoperative exploration was consistent with the description of the preoperative 3D modeling. The patient underwent the surgery successfully without any complications during the hospitalization, and the cardiopulmonary bypass time was 117 min, the aortic cross-clamping time was 57 min, and the hospital stay time was 7 d. The postoperative echocardiography demonstrated left ventricular cavity flow patency. This case provides a reference for the management of patients with apical hypertrophic cardiomyopathy.

Citation： TAN Tong, WEI Peijian, LIU Jian, ZANG Xin, ZHU Wei, WU Hongxiang, LIU Yanjun, LI Xiaoyi, ZHUANG Jian, GUO Huiming. Transapical approach under 3D printing guidance for myectomy in apical hypertrophic cardiomyopathy: A case report. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2023, 30(9): 1362-1366. doi: 10.7507/1007-4848.202202003 Copy

1.	Cardim N, Galderisi M, Edvardsen T, et al. Role of multimodality cardiac imaging in the management of patients with hypertrophic cardiomyopathy: An expert consensus of the European Association of Cardiovascular Imaging Endorsed by the Saudi Heart Association. Eur Heart J Cardiovasc Imaging, 2015, 16(3): 280.
2.	Klarich KW, Attenhofer Jost CH, Binder J, et al. Risk of death in long-term follow-up of patients with apical hypertrophic cardiomyopathy. Am J Cardiol, 2013, 111(12): 1784-1791.
3.	Lee CH, Liu PY, Lin LJ, et al. Clinical characteristics and outcomes of hypertrophic cardiomyopathy in Taiwan: A tertiary center experience. Clin Cardiol, 2007, 30(4): 177-182.
4.	Jan MF, Todaro MC, Oreto L, et al. Apical hypertrophic cardiomyopathy: Present status. Int J Cardiol, 2016, 222: 745-759.
5.	李华, 闫朝武, 徐仲英, 等. 肥厚型心肌病合并左心室心尖部室壁瘤患者的临床特征. 中国循环杂志, 2016, 31(7): 679-682.
6.	Abinader EG. Long-term outcome in patients with apical hypertrophic cardiomyopathy. J Am Coll Cardiol, 2002, 40(4): 837-838.
7.	Ono R, Iwahana T, Kobayashi Y. Ace-of-spades with tear drop sign in apical hypertrophic cardiomyopathy. QJM, 2021, 114(2): 130-131.
8.	Rowin EJ, Maron BJ, Haas TS, et al. Hypertrophic cardiomyopathy with left ventricular apical aneurysm: Implications for risk stratification and management. J Am Coll Cardiol, 2017, 69(7): 761-773.
9.	Xiao Y, Wang LP, Yang YK, et al. Clinical profile and prognosis of left ventricular apical aneurysm in hypertrophic cardiomyopathy. Am J Med Sci, 2016, 351(1): 101-110.
10.	Yang K, Song YY, Chen XY, et al. Apical hypertrophic cardiomyopathy with left ventricular apical aneurysm: Prevalence, cardiac magnetic resonance characteristics, and prognosis. Eur Heart J Cardiovasc Imaging, 2020, 21(12): 1341-1350.
11.	Kunkala MR, Schaff HV, Nishimura RA, et al. Transapical approach to myectomy for midventricular obstruction in hypertrophic cardiomyopathy. Ann Thorac Surg, 2013, 96(2): 564-570.
12.	Schaff HV, Brown ML, Dearani JA, et al. Apical myectomy: A new surgical technique for management of severely symptomatic patients with apical hypertrophic cardiomyopathy. J Thorac Cardiovasc Surg, 2010, 139(3): 634-640.
13.	Hang D, Schaff HV, Ommen SR, et al. Combined transaortic and transapical approach to septal myectomy in patients with complex hypertrophic cardiomyopathy. J Thorac Cardiovasc Surg, 2018, 155(5): 2096-2102.

1. Cardim N, Galderisi M, Edvardsen T, et al. Role of multimodality cardiac imaging in the management of patients with hypertrophic cardiomyopathy: An expert consensus of the European Association of Cardiovascular Imaging Endorsed by the Saudi Heart Association. Eur Heart J Cardiovasc Imaging, 2015, 16(3): 280.
2. Klarich KW, Attenhofer Jost CH, Binder J, et al. Risk of death in long-term follow-up of patients with apical hypertrophic cardiomyopathy. Am J Cardiol, 2013, 111(12): 1784-1791.
3. Lee CH, Liu PY, Lin LJ, et al. Clinical characteristics and outcomes of hypertrophic cardiomyopathy in Taiwan: A tertiary center experience. Clin Cardiol, 2007, 30(4): 177-182.
4. Jan MF, Todaro MC, Oreto L, et al. Apical hypertrophic cardiomyopathy: Present status. Int J Cardiol, 2016, 222: 745-759.
5. 李华, 闫朝武, 徐仲英, 等. 肥厚型心肌病合并左心室心尖部室壁瘤患者的临床特征. 中国循环杂志, 2016, 31(7): 679-682.
6. Abinader EG. Long-term outcome in patients with apical hypertrophic cardiomyopathy. J Am Coll Cardiol, 2002, 40(4): 837-838.
7. Ono R, Iwahana T, Kobayashi Y. Ace-of-spades with tear drop sign in apical hypertrophic cardiomyopathy. QJM, 2021, 114(2): 130-131.
8. Rowin EJ, Maron BJ, Haas TS, et al. Hypertrophic cardiomyopathy with left ventricular apical aneurysm: Implications for risk stratification and management. J Am Coll Cardiol, 2017, 69(7): 761-773.
9. Xiao Y, Wang LP, Yang YK, et al. Clinical profile and prognosis of left ventricular apical aneurysm in hypertrophic cardiomyopathy. Am J Med Sci, 2016, 351(1): 101-110.
10. Yang K, Song YY, Chen XY, et al. Apical hypertrophic cardiomyopathy with left ventricular apical aneurysm: Prevalence, cardiac magnetic resonance characteristics, and prognosis. Eur Heart J Cardiovasc Imaging, 2020, 21(12): 1341-1350.
11. Kunkala MR, Schaff HV, Nishimura RA, et al. Transapical approach to myectomy for midventricular obstruction in hypertrophic cardiomyopathy. Ann Thorac Surg, 2013, 96(2): 564-570.
12. Schaff HV, Brown ML, Dearani JA, et al. Apical myectomy: A new surgical technique for management of severely symptomatic patients with apical hypertrophic cardiomyopathy. J Thorac Cardiovasc Surg, 2010, 139(3): 634-640.
13. Hang D, Schaff HV, Ommen SR, et al. Combined transaortic and transapical approach to septal myectomy in patients with complex hypertrophic cardiomyopathy. J Thorac Cardiovasc Surg, 2018, 155(5): 2096-2102.

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Transapical approach under 3D printing guidance for myectomy in apical hypertrophic cardiomyopathy: A case report

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