Septal Myectomy and Concomitant Left Ventricular Outflow Tract Intervention for Obstructive Hypertrophic Cardiomyopathy

This article is part of CTSNet’s Guest Editor Series, “Operative Management of Obstructive Hypertrophic Cardiomyopathy—Gold Standard Septal Myectomy to Stand the Test of Time.” Guest editor Eduard Quintana has curated a robust collection of content that shares the knowledge, techniques, and insights of several distinguished experts from around the world. See the full series here. 

Septal myectomy for obstructive hypertrophic cardiomyopathy is a challenging operation. The ultimate goal is to achieve abolition of the obstruction and restore mitral valve competence. For many patients, surgical septal myectomy alone leads to this desired outcome. However, in some patients there may be associated abnormalities that pose risk for incomplete obstruction resolution. This video discusses several concomitant interventions at different levels of the left ventricular cavity and mitral valve apparatus. Judgmental use of such adjunct procedures may lead to full resolution of obstruction and preservation of the mitral valve. All these concomitant interventions can be performed through the same aortotomy, simplifying and expediting the operation. 

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