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(Circulation. 2005;111:2016-2018.)
© 2005 American Heart Association, Inc.

Editorial

Surgery for Hypertrophic Obstructive Cardiomyopathy

Alive and Quite Well

Barry J. Maron, MD

From The Hypertrophic Cardiomyopathy Center, Minneapolis Heart Institute Foundation, Minneapolis, Minn.

Correspondence to Barry J. Maron, MD, The Hypertrophic Cardiomyopathy Center, Minneapolis Heart Institute Foundation, 920 E 28th St, Suite 60, Minneapolis, MN 55407. E-mail hcm.maron@mhif.org

Key Words: Editorials • cardiomyopathy • hypertrophy • ablation • surgery

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Dynamic obstruction to left ventricular (LV) outflow as a result of mitral valve systolic anterior motion is a potentially deleterious facet of hypertrophic cardiomyopathy (HCM).^1–4 In many patients, outflow obstruction is largely responsible for disabling symptoms of heart failure such as exertional dyspnea (often with chest pain), fatigue, and orthopnea.^1,3 Consequently, treatment interventions that alleviate the subaortic gradient are critical therapeutic options for patients with HCM. Since the early 1960s, surgery (ie, ventricular septal myectomy) has been the primary treatment option for drug-refractory, severely symptomatic patients with the obstructive form of HCM.^5–14

See p 2033

	Surgical Experience

 
Several thousand patients with HCM have undergone surgical septal myectomy worldwide during the past 45 years. Pioneered by Dr Andrew Morrow at the National Institutes of Health,⁵ septal myectomy and related operations have been performed in a number of largely North American and Western European centers.^6–14

In this issue of Circulation, Woo et al¹⁵ report one of the most important single-center surgical series encompassing 338 adult patients consecutively assembled over 25 years at Toronto General Hospital, with Dr William G. Williams as the senior operating surgeon.⁶ Septal myectomy is traditionally performed through an aortotomy, creating a rectangular trough (usually 3.5 to 5.0 cm in length) by 2 parallel longitudinal incisions in the basal septum (2 to 3.5 cm apart). These incisions are extended distally and connected just beyond the point of mitral–septal contact and obstruction (Morrow procedure)⁵ or at the bases of papillary muscles (extended myectomy),¹⁴ yielding a residual septal thickness of 8 to . . . [Full Text of this Article]

Related Article:

Clinical and Echocardiographic Determinants of Long-Term Survival After Surgical Myectomy in Obstructive Hypertrophic Cardiomyopathy

Anna Woo, William G. Williams, Richard Choi, E. Douglas Wigle, Evelyn Rozenblyum, Katie Fedwick, Samuel Siu, Anthony Ralph-Edwards, and Harry Rakowski
Circulation 2005 111: 2033-2041. [Abstract] [Full Text]

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				B. J. Maron, J. A. Dearani, S. R. Ommen, M. S. Maron, B. J. Gersh, and R. A. Nishimura Reply J. Am. Coll. Cardiol., December 6, 2005; 46(11): 2146 - 2147. [Full Text] [PDF]

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