Hypertrophic cardiomyopathy is a genetic disorder of the myocardium, characterized by marked myocardial hypertrophy that may lead to the development of symptoms such as dyspnea, angina pectoris, or stress-induced syncopes, with an increased risk of sudden cardiac death, due to obstruction of the left ventricular outflow tract (hypertrophic obstructive cardiomyopathy). Septal reduction treatment is needed in these patients, in order to relieve of the symptoms. In addition, mitral valve apparatus should be assessed in these patients, in order to recognize a dynamic movement of the MV during systole anteriorly toward the LVOT. In this chapter, we will describe the current surgical management of HOCM.
Part of the book: Cardiac Surgery Procedures
The introduction of transcatheter aortic valve implantation (TAVI) have changed the management of patients affected by severe aortic stenosis. Nowadays, TAVI procedure represents the treatment of choice in patients with severe AS inoperable or at high risk. MDCT is the technique of choice in preoperative planning: it provides information regarding aortic valve and vascular access. Particular attention should be paid on bicuspid valve morphology. The choice of valve is, basically, based on confidence and experience of the operator and center.
Part of the book: Cardiac Surgery Procedures
Significant advancements have been made in Cardiac surgery during the last decades, thanks to technological evolution. The enormous progress achieved has led to a relevant improvement in terms of surgical results, and at the same time, new ethical dilemmas have been addressed. Until the 90’s ethics in cardiac surgery mainly concerned significant moral problems caused by the introduction of extremely innovative techniques. However, today’s ethical issue focuses essentially on the doctor-patient relationship, other aspects of doctor’s practice concern relevant ethical perspectives. Ethics affects today the activity of the surgeon and the doctor in general. It is possible to distinguish clinical ethics, an ethics of health policies, and scientific research ethics. In the following chapter, we try to analyze the main ethical aspects concerning the application of cardiac surgical procedures.
Part of the book: Bioethics in Medicine and Society