Overview: Myectomy is a surgical procedure used to treat obstruction in HCM, by reducing the thickness of the heart muscle.
A septal myectomy is used to treat the obstruction to blood flow that is caused by thickening of the heart muscle. More specifically, myectomy removes tissue from the septum that separates the left and right ventricles, below the aortic valve. Obstruction can cause symptoms including shortness of breath, exercise intolerance, and light-headedness and fainting.
Myectomy is a treatment option when symptoms of obstruction persist despite using medications, or if obstruction severely restricts blood flow. A myectomy eliminates or severely reduces the obstruction. After this procedure, patients often report feeling rapid relief of their symptoms.
Myectomy is not recommended unless symptoms of obstruction are serious. Centers of excellence (COEs) usually will not perform myectomies unless your gradient is at least 50 mmHg. The severity of symptoms is the major criterion for myectomy.