Dynamic left ventricular outflow tract obstruction is an important pathophysiologic feature of hypertrophic cardiomyopathy (HCM) and a predictor of clinical deterioration and cardiovascular mortality. Patients with marked obstruction and severe limiting symptoms refractory to maximum medical management are considered candidates for invasive septal reduction therapy, which includes surgical myec...

Patients with symptoms caused by hypertrophic obstructive cardiomyopathy are treated with β-blockers, verapamil, and disopyramide. Novel drugs are under development. The minority of patients whose symptoms interfere substantially with lifestyle despite optimal pharmacological management may be offered septal reduction therapy with ablation or myectomy. Other mechanical therapies, including shor...

We report a case of hypertrophic obstructive cardiomyopathy (HOCM) successfully treated with septal myectomy and mitral valve replacement (MVR) combined with a resection of the hypertrophic papillary muscles. The patient, a 74-year-old woman, first underwent the conventional septal myectomy through aortotomy. The papillary muscles revealed a marked hypertrophy, but extended myectomy and precise...

Hypertrophic obstructive cardiomyopathy (HOCM) is a primary, usually familial and genetically fi xed myocardial hypertrophy, with dynamic left ventricular outfl ow tract obstruction. An alternative to surgical myectomy in the treatment of severe, drug refractory, HOCM is percutaneous transluminal septal myocardial ablation (PTSMA). We report a case of  year old female patient who had the fi r...

Hypertrophic cardiomyopathy (HCM) – is the most common genetically determined heart disease, characterized by symmetrical or asymmetrical myocardial thickening (≥15 mm), leading to progressive failure and a high risk of sudden cardiac death (SCD). Diagnosis, natural course treatment HCM have become sources uncertainty, misunderstanding debate due increasing complexity diagnosis in clinical prac...

Abstract Background Although septal myectomy is a standard strategy for managing patients with hypertrophic obstructive cardiomyopathy (HOCM) and drug-refractory symptoms, so far, only few experienced centers exist globally. Mainly, this can be explained by the many technical challenges presented myectomy. From our clinical experience, applying mini-invasive surgical instruments during potentia...

Anomalous insertion of the papillary muscle (PM)/chordae tendineae is a rare but important cause of dynamic left ventricular outflow tract (LVOT) obstruction in patients with hypertrophic cardiomyopathy or cardiac amyloidosis. These anomalies are often challenging to diagnose with 2-D Echo, yet accurate diagnosis is critical in determining whether to proceed with an extended septal myectomy ins...

An 86-year-old woman presented with chest pain and discomfort. Echocardiography revealed severe aortic valve stenosis and asymmetric septal hypertrophy. Aortic valve replacement and myectomy were performed using a curved knife. The blade was U-shaped in cross-section, and was curved upward along the long axis. Hypertrophic septal myocardium was removed along the long axis of the left ventricle ...