Transapical Myectomy for Septal Hypertrophy Not Accessible Through the Aortic Root

Mayo Clinic surgeons describe and illustrate the techniques they utilize to relieve obstruction in hypertrophic cardiomyopathy in those circumstances where it is difficult to adequately expose the basal and midventricular septum through the aortic root. In selected patients, either at primary myectomy or at redo myectomy, septal excision can be approached through a left ventricular transapical incision. This important alternative should be considered in cases where successful relief of dynamic basal or midventricular obstruction cannot be accomplished through the aorta.