Septal myectomy is a cardiac surgery treatment for

hypertrophic cardiomyopathy Hypertrophic cardiomyopathy (HCM, or HOCM when obstructive) is a condition in which muscle tissues of the heart become thickened without an obvious cause. The parts of the heart most commonly affected are the interventricular septum and the ...

(HCM). The open-heart surgery entails removing a portion of the

septum In biology, a septum (Latin language, Latin for ''something that encloses''; septa) is a wall, dividing a Body cavity, cavity or structure into smaller ones. A cavity or structure divided in this way may be referred to as septate. Examples Hum ...

that is obstructing the flow of blood from the left ventricle to the

aorta The aorta ( ; : aortas or aortae) is the main and largest artery in the human body, originating from the Ventricle (heart), left ventricle of the heart, branching upwards immediately after, and extending down to the abdomen, where it splits at ...

. The most common alternatives to septal myectomies are treatment with medication (usually

beta Beta (, ; uppercase , lowercase , or cursive ; or ) is the second letter of the Greek alphabet. In the system of Greek numerals, it has a value of 2. In Ancient Greek, beta represented the voiced bilabial plosive . In Modern Greek, it represe ...

or calcium blockers) or non-surgical thinning of tissue with alcohol ablation. Ordinarily, septal myectomies are performed only after attempts at treatment with medication fail. The choice between septal myectomy and alcohol ablation is a complex medical decision. Septal myectomy was established by Andrew G. Morrow in the 1960s. __TOC__

Outcomes

Septal myectomy is associated with a low perioperative mortality and a high late survival rate. A study at the

Mayo Clinic Mayo Clinic () is a Nonprofit organization, private American Academic health science centre, academic Medical centers in the United States, medical center focused on integrated health care, healthcare, Mayo Clinic College of Medicine and Science ...

found surgical myectomy performed to relieve outflow obstruction and severe symptoms in HCM was associated with long-term survival equivalent to that of the general population, and superior to obstructive HCM without operation. The results are shown below:

Comparison with alcohol ablation

Either alcohol ablation or myectomy offers substantial clinical improvement for patients with hypertrophic obstructive cardiomyopathy. One non-randomized comparison suggested that hemodynamic resolution of the obstruction and its sequelae are more complete with myectomy. Whether one or the other treatment is preferable for certain patient types is debated among cardiovascular scientists.

References

{{cardiac surgery Cardiac surgery Cardiomyopathy