Septal myectomy is a complex surgical procedure to relieve hypertrophic cardiomyopathy (HCM), a rare and often inherited disease which occurs when the muscle of the heart's left ventricle becomes thicker than normal, obstructing blood flow to the rest of the body. Hypertrophic cardiomyopathy forces the heart to work harder to pump blood, and may also affect the mitral valve, causing blood to leak backward through the valve and therefore less to the body. Treatment for HCM includes medication, ablation and implantable cardioverter defibrillator devices. When these treatments do not work or when a patient has an obstruction that restricts blood flow out of the heart, septal myectomy is often the most effective option, relieving the severe symptoms of obstructive HCM.
Cardiac surgeons at the Brigham and Women’s Hospital (BWH) Heart & Vascular Center have extensive experience performing septal myectomy surgery. Their advanced training and collaboration with a multidisciplinary team of cardiac specialists through the Center for Advanced Heart Failure/Cardiomyopathy Program enables our surgeons to handle the most complicated cases.
With 47,000 outpatient visits each year, the Heart & Vascular Center is one of the largest in the United States, treating over 7,000 inpatients and performing more than 8,000 procedures annually at our state-of-the-art Shapiro Cardiovascular Center.
Septal myectomy is an open surgery procedure that requires the support of a heart-lung machine. Your surgeon will divide the breastbone (median sternotomy) and gain access to the heart. A part of the thickened septum will be removed to relieve the obstruction. Occasionally, the mitral valve continues to leak and your surgeon may also perform repairs to the mitral valve.
Patients suffering from debilitating symptoms of hypertrophic cardiomyopathy who cannot gain relief from medication or other less invasive treatment options may be candidates for septal myectomy surgery. They may experience these symptoms:
The Heart & Vascular Center is located in the Shapiro Cardiovascular Center, across the street from BWH’s main 75 Francis Street entrance. The Heart & Vascular Center brings together the full range of services in one location, fostering seamless and coordinated care for all cardiovascular patients.
Prior to surgery or a procedure, you will be scheduled for a visit to the Watkins Clinic in the Shapiro Cardiovascular Center for preoperative information and tests.
The day of surgery, your care will be provided by surgeons, anesthesiologists and nurses who specialize in septal myectomy surgery. The Heart & Vascular Center is home to one of the most advanced hybrid operating rooms in the country. After surgery, you will recover in the post-surgical care unit where you will receive comprehensive care by an experienced surgical and nursing staff.
During your surgery, family and friends can wait in the Shapiro Family Center where staff members will provide surgery updates.
In addition to our cardiac surgeons, patients also benefit from the teamwork of medical cardiologists, interventional cardiologists, cardiovascular imaging experts and radiologists, and anesthesiologists, all experts in cardiovascular disease. They work alongside nurses, physician assistants, physical therapists, dietitians and social workers to achieve outstanding outcomes for our patients.