Septal myectomy is a cardiac surgery treatment for hypertrophic cardiomyopathy (HCM).[1] The open-heart surgery entails removing a portion of the septum that is obstructing the flow of blood from the left ventricle to the aorta.[2]
Septal myectomy | |
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Specialty | Cardiology |
The most common alternatives to septal myectomies are treatment with medication (usually beta 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.[citation needed]
Septal myectomy was established by Andrew G. Morrow in the 1960s.[3]
Septal myectomy is associated with a low perioperative mortality and a high late survival rate. A study at the Mayo Clinic 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:[4]
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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.[5] Whether one or the other treatment is preferable for certain patient types is debated among cardiovascular scientists.[6]