Surgical treatment of hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy (HCM) is a clinical entity in which there is unexplained hypertrophy of the left ventricle in the absence of another cardiac or systemic etiology. Variants of HCM may include basal, midventricular, apical or diffuse types. In this review, the authors summarize the current surgical treatment and outcomes of septal myectomy in HCM. HCM is a unique primary myocardial disease characterized by hypertrophy of the myocardium. It is associated with a variety of presentations that range from asymptomatic to sudden cardiac death. Previously known as idiopathic hypertrophic subaortic stenosis, HCM is recognized as a genetic predisposition to myocardial hypertrophy. Medical treatment is the first-line therapy for patients with symptoms due to left ventricular outflow tract obstruction. However, septal myectomy continues to be an excellent treatment option for those intolerant of or unresponsive to medical therapy. In this paper, the authors review the role of surgery in HCM and the different variants of this unique disease.