Related Experiment Video

Updated: Jan 31, 2026

Investigating the Pathogenesis of MYH7 Mutation Gly823Glu in Familial Hypertrophic Cardiomyopathy using a Mouse Model
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Investigating the Pathogenesis of MYH7 Mutation Gly823Glu in Familial Hypertrophic Cardiomyopathy using a Mouse Model

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Extended septal myectomy for obstructive hypertrophic cardiomyopathy - still the gold standard?

Younus Qamar1, Hartzell V Schaff1

  • 1Department of Cardiovascular Surgery, Mayo Clinic, Saint Marys Campus, 1216 2nd Street, Rochester, MN 55902 USA.

Indian Journal of Thoracic and Cardiovascular Surgery
|January 30, 2026
PubMed

Insights

Surgical septal myectomy is the best treatment for obstructive hypertrophic cardiomyopathy (oHCM), significantly improving symptoms and relieving left ventricular outflow tract (LVOT) obstruction with low mortality. It offers superior outcomes compared to other methods, restoring life expectancy.

Area of Science:

  • Cardiovascular Surgery
  • Cardiology
  • Medical Devices

Background:

  • Obstructive hypertrophic cardiomyopathy (oHCM) significantly impacts patient quality of life and survival.
  • Symptomatic oHCM requires effective interventions to relieve left ventricular outflow tract (LVOT) obstruction.

Purpose of the Study:

  • To evaluate the efficacy and safety of surgical septal myectomy for obstructive hypertrophic cardiomyopathy (oHCM).
  • To compare surgical septal myectomy outcomes with alternative treatments and assess the impact of institutional volume.

Main Methods:

  • Review of outcomes for patients undergoing transaortic septal myectomy.
  • Analysis of factors influencing complication rates, including mitral valve (MV) procedures and institutional surgical volume.

Main Results:

  • Surgical septal myectomy provides symptomatic improvement in over 90% of oHCM patients.
  • Operative mortality is low (<0.5%) at experienced centers, with sustained LVOT obstruction relief.
  • High-volume centers demonstrate better outcomes, with lower rates of MV replacement and complications compared to low-volume centers.
  • Septal myectomy restores life expectancy and offers superior outcomes to alcohol septal ablation, especially in complex cases.

Conclusions:

  • Surgical septal myectomy is the definitive, gold-standard treatment for symptomatic oHCM.
  • Patient selection and surgical expertise are critical for optimal outcomes.
  • Despite emerging pharmacologic therapies, myectomy remains the most effective intervention for refractory LVOT obstruction.

Keywords:
Mitral valveObstructive hypertrophic cardiomyopathySeptal myectomy

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