Efficacy and Safety of a Transaortic Approach to Midventricular and Apical Septal Myectomy

This article summarizes the outcomes of 940 patients who underwent transaortic septal myectomy at Cleveland Clinic over a period of five years. A total of 682 (73 percent) of these patients had midventricular and/or apical resection, of which 582 (85 percent) had basal plus midventricular resection and 78 (11 percent) had basal, midventricular, and apical resection. The median resection weight was 10 grams. The authors describe the safety and feasibility of this transaortic approach to midventricular and apical septal myomectomy in experienced hands and report that no patients underwent a left ventriculotomy for the procedure. They also detail how extending beyond the basal septum is important to prevent residual obstruction.