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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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.
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.
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:
People with HOCM who want to get pregnant may also need this surgery.
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.
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.
Your doctor will explain the surgery and discuss the risks with you. You’ll undergo a series of tests to make sure you’re a good candidate.
Your doctor may order:
You will receive general anesthesia for this surgery. You will be completely asleep with a breathing tube.
Septal myectomy is an open heart surgery. The surgeon will make an incision in the middle of your chest to access your heart. This is called a sternotomy.
Next, the surgeon connects you to a heart-lung machine and stops your heart. This is called cardiopulmonary bypass. This machine keeps your heart and lungs working while your heart is stopped.
Then, the surgeon removes a small part of the thickened muscle of the septal wall. They’ll gauge how much to remove based on how thick it is.
When surgery is complete, the surgeon will allow your heart to start beating again and remove you from the heart-lung machine. The surgeon will then close the incision.
Typically, the surgery takes three to four hours.
After septal myectomy surgery, your doctor will provide instructions for post-op care.
Most people will spend between three and five days in the hospital after a septal myectomy.
You’ll be sore around your incision for a couple of weeks. Your doctor will prescribe medicine to help with pain and prevent infection. Your team will go over how to care for your incision and any activity limits. Recovery from a sternotomy is generally four to six weeks. For the first four weeks, you will not be permitted to drive or lift more than 10 pounds.
Once your doctor clears you, you can attend cardiac rehab. This supervised exercise program can help you get your strength back. You’ll work one-on-one with a rehab specialist to create a program that works for you.
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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