Surgery for hypertrophic obstructive cardiomyopathy: alive and quite well.

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