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)

  • Infection

  • Bleeding

  • 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:

  • Chronic illness

  • Other heart conditions

  • Lung problems

  • Advanced age

  • Obesity

  • History of smoking

  • Infections

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.