Improving surgical management of hypertrophic cardiomyopathy with echocardiographic guidance

The value of echocardiography before and during surgery for planning and guiding septal myectomy to ensure adequate, controlled reduction of the left ventricular outflow tract gradient was evaluated in 50 hypertrophic cardiomyopathy patients. Based on the surgical result, the initial myectomy attempt was successful in 40 patients; 10 required further surgery. At follow-up, the outflow tract gradient was similar for both groups. Echocardiography proved useful both preoperatively for assessing the extent of the obstruction and location of its site, and intraoperatively for identifying patients requiring more extensive surgery.