[MSB-12] Our Clinical Experience with Septal Myectomy in Hypertrophic Cardiomyopathy Patients

This study aimed to share our surgical experience of patients with hypertrophic cardiomyopathy (HCM) treated successfully with surgical myectomy at a tertiary center that frequently utilizes minimally invasive approaches in clinical practice.

This study was conducted with eight patients (5 males, 3 females; mean age: 49.2±12.5 years) patients who underwent surgery for HCM between 2017 and 2024.

All patients were symptomatic. Four of the patients had concomitant mitral valve pathologies requiring surgery, with one patient also having aortic valve pathology. Preoperative mean gradients were 49.1±22.8 mmHg at rest and 102.8±27.2 mmHg with the Valsalva maneuver. One surgery was performed via sternotomy. Two patients were operated on with anterolateral thoracotomy technique and five with a minimally invasive robotic approach. Four patients underwent isolated myectomy. The mean cardiopulmonary bypass time was 165.5±53.8 min, and the mean cross-clamp time was 112.1±42.5 min. No intraoperative complications were observed. A third-degree atrioventricular block, which was treated with an implantable cardioverter-defibrillator, was the only postoperative complication. The mean hospital stay was 7.5±2 days, with a mean intensive care unit stay of 2.38±1.77 days.

Hypertrophic cardiomyopathy is a genetic cardiac disorder with a heterogeneous spectrum of clinical manifestations. Septal reduction therapies are the primary treatment for patients. Septal myectomy has been shown to be effective, providing a reduction in outflow tract gradient and symptoms. Currently, myectomy is the recommended treatment for HCM, and it can be performed via conventional median sternotomy or minimally invasive approaches.