Understanding Septal Myectomy
Septal myectomy is a type of open-heart surgery. It’s done to treat hypertrophic cardiomyopathy. This is when part of the heart muscle becomes thick. The surgery helps lessen symptoms of the condition.
What is hypertrophic cardiomyopathy?
The heart has 4 chambers. The 2 lower chambers are called ventricles. The left and right ventricles are separated by a wall of muscle. It’s called the septum. With hypertrophic cardiomyopathy, the walls of the septum and the ventricles may get thick. The septum may bulge into the left ventricle. This can partly block the blood flow out to the body. This causes the heart to work harder. It also causes symptoms such as tiredness and feeling short of breath.
Why septal myectomy is done
In many cases, medicine can relieve the symptoms. But if medicine doesn’t work well to relieve symptoms, a septal myectomy often works. A woman with hypertrophic cardiomyopathy may need the surgery before becoming pregnant. This may be the case even if her symptoms aren’t severe.
How septal myectomy is done
During septal myectomy, a surgeon removes extra muscle from the thickened septum. This lets the blood empty from the ventricle more easily.
Risks of septal myectomy
All procedures have risks. The risks of septal myectomy include:
Irregular heart rhythms, such as heart block (see below)
Blood clots that can lead to stroke or heart attack
Problems from anesthesia
Aortic valve problems because of movement of the valve in surgery
Removal of too much heart muscle
Blood flow problems during surgery that can lead to poor pumping of the heart in the future
Your own risks may vary based on your age and your overall health. Ask your health care provider which risks apply most to you. You may have a higher risk of problems if you have any of the below:
Other heart conditions
History of smoking
Heart block after septal myectomy
Heart block is a common problem after this surgery. Heart block is a disruption to the electrical signals through the heart. This can cause your heart to skip beats. Or it may beat too slowly. Some kinds of heart block need treatment with a pacemaker.
March 21, 2017
Fifer MA, Sigwart U. Hypertrophic obstructive cardiomyopathy: alcohol septal ablation. Eur Heart J. 2011;32:1059-64., Masry HE, Breall JA. Alcohol septal ablation for hypertrophic obstructive cardiomyopathy. Curr Cardiol Rev. 2008;4:193-7., Nonpharmacologic treatment of outflow obstruction in hypertrophic cardiomyopathy. UpToDate.
Fetterman, Anne, RN, BSN,Mancini, Mary, MD