Congratulations to Raffa et al. on their study [
[1]
]. We wish to highlight some issues regarding their paper. The pathophysiological
mechanism of the development of mitral regurgitation differs between hypertension
and hypertrophic obstructive cardiomyopathy (HOCM). In HOCM, interventricular septum
(IVS) and the anterior leaflet of the mitral valve approach each other owing to hypertrophy
of IVS. Thus, the jet-like flow through the left ventricular outflow tract (LVOT)
causes the Venturi effect and drags the anterior leaflet, leading to mitral regurgitation,
which is called systolic anterior motion (SAM). In their paper, the authors stated
that secondary chordae tendineae tractioning the anterior leaflet to IVS and SAM was
seen in 22 cases (78%). What the cause of mitral regurgitation was in the remaining
22% is unclear. In Table 1, IVS thickness was only measured preoperatively. It may
have been better to also measure the postoperative IVS thickness. Pathological examination,
pre- and postoperative pressure gradients through the LVOT, and the remaining degree
of mitral regurgitation after surgery would add to the scientific value of the paper.To read this article in full you will need to make a payment
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Reference
- Pathoanatomic findings and treatment during hypertrophic obstructive cardiomyopathy surgery: the role of mitral valve.Heart Lung Circ. 2019; 28: 477-485
Article info
Publication history
Published online: April 14, 2020
Accepted:
March 7,
2020
Received:
February 5,
2020
Identification
Copyright
© 2020 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
