Related Experiment Video

Updated: Jan 31, 2026

Investigating the Pathogenesis of MYH7 Mutation Gly823Glu in Familial Hypertrophic Cardiomyopathy using a Mouse Model
03:45

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

Published on: August 8, 2022

4.3K

Surgical management of hypertrophic cardiomyopathy

Chandrasekaran Ananthanarayanan1, SriKrishna Reddy Modugula1, Vincent Chauvette1

  • 1Department of Thoracic and Cardiovascular Surgery, Heart Vascular and Thoracic Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195 USA.

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

Insights

Surgical myectomy offers a curative solution for symptomatic hypertrophic cardiomyopathy (HCM) patients unresponsive to medication. This procedure safely reduces left ventricular outflow tract obstruction, improving long-term survival and quality of life.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Medical Research

Background:

  • Hypertrophic cardiomyopathy (HCM) presents a wide clinical spectrum, from incidental findings to sudden cardiac death.
  • Medical management is the initial approach for symptomatic patients, with new drugs under investigation.
  • Invasive therapy, specifically surgical myectomy, is indicated for patients with persistent symptoms despite maximal medical therapy and offers better long-term survival.

Purpose of the Study:

  • To analyze the outcomes of surgical myectomy for hypertrophic cardiomyopathy (HCM) performed between 2005 and 2015.
  • To evaluate the effectiveness of septal myectomy in reducing left ventricular outflow tract (LVOT) obstruction.
  • To assess the safety and complication rates associated with surgical myectomy in a large patient cohort.

Main Methods:

  • Retrospective analysis of 1549 patients who underwent surgical myectomy for HCM.
  • Evaluation of pre- and post-operative left ventricular outflow tract (LVOT) gradients.
  • Assessment of operative parameters including aortic cross-clamp time and muscle resection mass.
  • Review of complication rates, operative mortality, hospital stay, and post-operative functional status (NYHA class).

Main Results:

  • Surgical myectomy significantly reduced the mean LVOT gradient from 63 mmHg pre-operatively to 15 mmHg post-operatively.
  • The mean aortic cross-clamp time was 28 minutes, with an average of 8.1 g of muscle resected.
  • Low complication rates were observed, including 4.2% pacemaker insertion, two iatrogenic ventricular septal defects, and an operative mortality of 0.38%.
  • Mean hospital stay was 6 days, with most patients achieving New York Heart Association (NYHA) class I post-operatively.

Conclusions:

  • Septal myectomy is a curative treatment for symptomatic HCM patients refractory to medical management.
  • A thorough understanding of individual septal anatomy and LVOT obstruction mechanisms is crucial for successful surgical outcomes.
  • Surgical myectomy can be performed safely, yielding excellent long-term results and significantly improving patient functional status.
Abstract

Keywords:
Alcohol septal ablationHypertrophic cardiomyopathySeptal Myectomy

More Related Videos

A Mouse Model of Mechanotransduction-driven, Human-like Hypertrophic Scarring05:54

A Mouse Model of Mechanotransduction-driven, Human-like Hypertrophic Scarring

Published on: November 29, 2024

2.2K
Surgical Management of Meatal Stenosis with Meatoplasty04:53

Surgical Management of Meatal Stenosis with Meatoplasty

Published on: November 30, 2010

54.8K

Related Concept Videos

Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
486
Cardiomyopathy VI: Nursing Management01:29

Cardiomyopathy VI: Nursing Management

Assessment: Nursing management of patients with cardiomyopathy begins with a thorough assessment of the patient's history, including a family history of cardiomyopathy or sudden cardiac death, personal history of heart disease, hypertension, diabetes, and any alcohol consumption or drug use.During the physical examination, assess vital signs, look for signs of heart failure (such as edema, jugular venous distention, and cyanosis), auscultate for abnormal heart sounds (like murmurs and gallops),...
354
Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
346
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
563
Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
516
Urinary Tract Calculi VI: Surgical Management01:25

Urinary Tract Calculi VI: Surgical Management

Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
502