Thoracoscopic Transmitral Myectomy of Apical HOCM with Concomitant Valve
Procedure with 3D Printing Technique Assistant: Response to Letter to
the Editor
Abstract
We thank Shixiong Wei et al for their interest in our technical paper on
Robotic Septal myectomy for HOCM and their letter to the editor. Their
technique of using the Computed Tomography Angiography (CTA) along with
3D Printing technology for the better delineation of the anatomy of HOCM
has been an evolving way to approach the problem. As they have mentioned
in their letter, we used cardiac magnetic resonance imaging (MRI)
predominantly for all our patients who undergo septal myectomy. Using 3D
printing technology augmenting CTA or MRI can certainly augment the
surgical planning in complex patients. In their case report, Wei et al
have shaved off most of the subvalvular tissue along with the mitral
valve. Removal of the entire mitral valve definitely would have enhanced
the exposure to the mid-ventricular cavity and the apex for their
thoracoscopic approach. It will be interesting to know whether they
tried to repair the valve before replacement. Our technique of Robotic
mitral valve repair, septal myectomy, and particularly papillary muscle
re-orientation tries to preserve the sub-valvular apparatus even after
completely relieving the mid-cavitary obstruction and this may provide
better ventricular re-modeling. We congratulate them on providing a
successful surgical option to this complex subset of patients using
novel evolving technology and meticulous surgical planning.