Transcatheter Myotomy to Reduce Left Ventricular Outflow Obstruction

Researchers explore the use of a novel transcatheter electrosurgical technique, SESAME, for treating left ventricular outflow tract (LVOT) obstruction. This procedure, designed to mimic surgical myotomy, was tested on 76 patients between 2021 and 2023. SESAME successfully reduced LVOT gradients in hypertrophic cardiomyopathy (HCM) patients and improved LVOT dimensions to facilitate transcatheter mitral and aortic valve replacements. The procedure showed a high success rate with a low incidence of serious complications, though some patients required permanent pacemakers. SESAME appears promising for both reducing obstruction in HCM and aiding in valve implantation procedures.