Transapical Beating-Heart Septal Myectomy for Hypertrophic Cardiomyopathy With Latent Obstruction

A novel transapical beating-heart septal myectomy (TA-BSM) procedure was performed for patients with latent obstruction and outcomes were compared with those for patients with resting obstruction. The population was comprised of 120 patients with symptomatic hypertrophic obstructive cardiomyopathy, 33 with latent obstruction, and 87 with resting obstruction. There were no important differences in baseline characteristics, but those with latent obstruction had lower basal septal thickness, higher midventricular thickness, smaller left atria, and higher frequency of mitral subvalvular anomalies. After surgery, there was no significant difference in early deaths or midterm survival and the New York Heart Association class was significantly improved. This novel TA-BMS procedure achieved equivalent outcomes regardless of resting left ventricular outflow tract gradients.