Belarusian Surgeons Performed a Unique Heart Surgery

According to the center's specialists, there are no descriptions in published world medical literature of operations where such a large volume of tissue was removed in this manner.

The patient was diagnosed with hypertrophic cardiomyopathy — a disease in which the heart muscle thickens excessively. As a result, the internal space of the heart decreases, and blood flow through it becomes more difficult.

Павялічыць

The Belarusian patient had a particularly complex, diffuse form of the disease: the muscle thickened not in one place, but in several areas of the left ventricle, including near its apex. According to the results of computed tomography, in one of the areas, the heart muscle thickness reached 40 millimeters — four centimeters.

Before the surgery, doctors created a three-dimensional model of the heart based on computed tomography and ultrasound data. This allowed them to accurately determine where and how much tissue needed to be removed.

Surgeons performed myoseptectomy — an operation during which a part of the thickened heart muscle that obstructs normal blood flow is removed.

The main difficulty was reaching the most inaccessible areas. Doctors operated through the aorta — the largest blood vessel through which blood exits the heart. They managed to penetrate 10 centimeters deep from the aortic valve and remove excess tissue even near the apex of the heart.

It was not necessary to additionally incise the apex, thereby avoiding additional heart trauma associated with such an approach.

In total, the surgeons removed 36.3 grams of tissue — more than 10% of the original mass of the left ventricular muscle. For comparison, at the American Cleveland Clinic, in a series of 682 similar operations performed between 2018 and 2023, the largest mass of removed tissue was 32 grams. Thus, Belarusian specialists exceeded this indicator by 4.3 grams, using only one access point through the aorta.

After the operation, the patient's maximum heart muscle thickness decreased from 40 to 18 millimeters. The pressure gradient also decreased — an indicator that allows assessing how much blood outflow from the heart is hindered. It decreased from 38 to 6 millimeters of mercury.

At the same time, the heart retained its ability to contract normally, and its natural rhythm was not disturbed. The postoperative period passed without complications. On the 12th day, the patient was discharged from the hospital in satisfactory condition. According to information from the Republican Scientific and Practical Center "Cardiology", he is currently feeling well.

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