Transapical approach for myectomy in hypertrophic cardiomyopathy.

A 61-year-old woman is a known case of hypertrophic cardiomyopathy (HCM) for three years. She has symptoms of breathlessness on exertion and fatigability. Her echocardiogram shows a mid-ventricular variant of HCM with an aneurysmal apical pouch. There is a midventricular gradient of 30–40 mmHg. There is no evidence of subaortic obstruction. We advised a trans-apical mid ventricular myectomy with apical pouch repair.