Paradoxical artificial cords technique to treat SAM in HOCM

Presented at the 23rd European Congress of heart disease and heart failure in Paris, an original conservative technique for the treatment of anterior systolic movement (SAM) with artificial cords.

5 March Mar 2018 0000 6 years ago

The systolic anterior motion (SAM) of mitral valve (MV) and the asymmetric hypertrophy of left ventricular septum are the two components responsible for left ventricular outflow obstruction (LVOTO) in hypertrophic obstructive cardiomyopathy (HOCM). The transaortic left ventricular septal myomectomy has been proposed as the gold standard surgical procedure for symptomatic patients with severe HOCM since the late 1960s.

The Authors have previously described1 one technique to prevent systolic anterior motion post MV repair, the so-called “paradoxical artificial cords to prevent SAM after MV repair”. A new study2 aims now to demonstrate the efficacy of this technique also to treat SAM in HOCM patients, in case of concomitant moderate septal myectomy.

The 5 patients enrolled for the study had both SAM and left ventricular outflow obstruction. All of them have been surgically treated, performing moderate transaortic septal myomectomy and correction of SAM by paradoxical artificial cords and ring annuloplasty.

The postoperative course of all patients was regular. No one of them developed the usual complications of this surgery (Ventricular Septal Defect [VSD] or Pacemaker [PM] implantation). Transthoracic Echocardiography TTE has demonstrated good result of the early postoperative interventricular gradient. The MV function was preserved and free of SAM.


  1. Kassem S, Othman M, Polvani G. Paradoxical Artificial Chords: New Technique to Prevent Systolic Anterior Motion Post Mitral Valve Reconstructions. J Clinic Experiment Cardiol 2011; S:3. DOI: 10.4172/2155-9880.S3-002.
  2. Kassem S. Paradoxical artificial cords technique to treat SAM in HOCM. 23rd European Heart Disease and Heart Failure Congress February; Paris 19-21 2018.