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Residual midventricular obstruction after transaortic myectomy may lead to recurrent symptoms and reoperation in patients with hypertrophic cardiomyopathy and long-segment septal hypertrophy. A combined transaortic and transapical approach to septal myectomy during initial operation allows for the complete relief of subaortic and midventricular gradients and may reduce the risk of poor late functional results.

Combined transaortic and transapical approach to septal myectomy in patients with complex hypertrophic cardiomyopathy