Background: Percutaneous transluminal septal myocardial ablation (PTSMA) and modified Morrow septal myectomy
(MMSM) are two invasive strategies used to relieve obstruction in patients with hypertrophic cardiomyopathy (HCM).
If a patient has both conditions, surgical aortic valve replacement (SAVR) with septal myectomy
or, alternatively, alcohol septal ablation (ASA) followed by transcatheter aortic valve implantation (TAVI) should be considered [2, 3].
Currently, the standard of treatment for HOCM, aside from managing cardiac risks, is septal myectomy
All of the patients were receiving beta-blocker treatment, and one subject had undergone septal myectomy
(1) Morrow and colleagues successfully relieved the obstruction first by ventricular septal myotomy (7) and later, by septal myectomy
. (8) Angiocardiographers (9,10) and then echocardiographers11 described the location of obstruction in hypertrophic cardiomyopathy as the site of apposition of the edge of the anterior mitral leaflet to the hypertrophied ventricular septum during systole, the result of systolic anterior motion of the anterior leaflet.
Obstructed patients, who fail medical therapy, are usually offered invasive treatment: surgical septal myectomy
, alcohol septal ablation, or DDD pacemaker.
After consultations with specialists in structural heart disease and cardiothoracic surgery, the patient ultimately underwent cardiac surgery consisting of very gentle septal myectomy
focusing more midventricular at the basilar septum, reorientation of the posterior medial papillary muscle head, resection of the tethering secondary chordae to the A1 segment of the mitral valve, and chordal shortening and tacking of the chordae to the A1 and A2 segments of the mitral valve.
The most recent literature is reviewed for both septal myectomy
and alcohol ablation.
For the typical HCM patient with drug-refractory symptoms, surgery with septal myectomy
is the first-line therapeutic approach [20, 21].
Objective: The surgical management of left ventricular outflow tract (LVOT) obstruction secondary to hypertrophic cardiomyopathy (HCM) has classically consisted of a septal myectomy
. To address inconsistent results the extended myectomy or resection (R) and papillary muscle release (R) have been described.
Patients with persistent symptoms after medical therapy with a left ventricular outflow tract (LVOT) gradient of >50 mm Hg are referred for septal myectomy
. A review of both early and recent literature of outcomes of surgical therapy was performed.
Some HCM patients undergo surgical septal myectomy
to correct outflow obstruction.