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Septal Myectomy

Septal myectomy is an open heart surgery used to treat obstructive hypertrophic cardiomyopathy (HOCM), a condition that causes the muscle fibers of the heart to thicken, affecting the heart’s ability to pump blood.

This surgery helps improve blood flow by removing a portion of the thickened heart muscle. Septal myectomy is the preferred treatment option for people who have severe symptoms despite optimal medical therapy. Symptoms can include fatigue, breathing problems, chest pain, and irregular heart rhythms.

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What Is Septal Myectomy?

Septal myectomy is a surgical procedure to treat obstructive hypertrophic cardiomyopathy.

HOCM is a disease that affects your heart muscle, specifically how it pumps blood. HOCM makes the muscle wall between your left and right ventricle thicken.

Your left ventricle’s job is to pump blood to the rest of the body. But when the wall, or septum, gets too thick, it gets in the way of that blood flow. Doctors call this obstructive hypertrophic cardiomyopathy.

The goal of a septal myectomy surgery is to remove that obstruction. The heart surgeon thins out the thickened septum by removing some of the muscle.

Septal myectomy requires general anesthesia and cardiopulmonary bypass. You’ll spend three to five days in the hospital to recover after surgery.

Conditions We Treat with Septal Myectomy

Septal myectomy surgery is used to treat obstructive hypertrophic cardiomyopathy (HOCM).

HOCM is the most common type of inherited heart disease in the U.S., affecting about 1 in 500 adults.

Why Would I Need Septal Myectomy Surgery?

HOCM can affect each person differently. This is why our team will create a personalized treatment plan for you.

Your doctors may suggest septal myectomy to treat HOCM if lifestyle changes and medications don’t work.

You may be a candidate for septal myectomy if you:

  • Have significant thickening of your left ventricle.
  • Have severely obstructed blood flow.
  • Are healthy enough for heart surgery.

People with HOCM who want to get pregnant may also need this surgery.

Alternatives to septal myectomy

Your doctor may talk to you about alcohol septal ablation (ASA) as an alternative to septal myectomy if your risk for surgery is too high.

ASA is less invasive than septal myectomy. Instead, this technique is done through cardiac catheterization.

First, doctors insert a catheter, or small tube, into an artery near your groin. They then thread the catheter through the artery up to your heart.

The doctor then injects alcohol, which is toxic to the heart muscle cells. The alcohol solution kills enough of the cells to thin the heart wall.

While surgical myectomy is the preferred method to remove the thickened heart muscle, ASA is an alternative for people who are too high-risk for surgery.

Research shows that in centers that offer both ASA and myectomy, younger people who have severe symptoms get better relief with myectomy. ASA also has a higher risk of arrhythmia.

Septal Myectomy Risks

As with any open heart surgery, septal myectomy poses risks.

Since the procedure can interfere with your heart’s electrical system, there’s a small chance you may need a pacemaker.

Some people also experience atrial fibrillation after surgery.

If you’re older than 65, have other heart issues, or you smoke, your risks for complications are greater.

Septal Myectomy: What Should I Expect?

Why Choose UPMC for Your Septal Myectomy Surgery?

When you choose the UPMC Heart and Vascular Institute, you’ll receive high-quality, comprehensive care from a top-rated, high-volume center.

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