Penn Medicine’s cardiac surgeons have more expertise performing septal myectomy for hypertrophic cardiomyopathy than anyone in the region. We are one of just a few centers in the nation that perform this procedure.
From pre-operative consultations through post-surgical cardiac rehabilitation, patients undergoing septal myectomy receive the expertise and support needed for successful treatment.
What Is Septal Myectomy?
Septal myectomy is a type of open-heart surgery to treat hypertrophic cardiomyopathy (HCM), a condition that causes the walls of the heart ventricles to thicken and stiffen over time, slowing blood flow through the body. A septal myectomy procedure reduces the thickness and overgrown areas of the wall (cardiac septum) separating the right and left ventricles of the heart. This separation widens the opening in the left ventricle through which blood flows out of the heart, delivering rapid symptom relief.
Who Is a Candidate for Septal Myectomy?
Depending on the severity of the condition, patients with hypertrophic cardiomyopathy are typically given medication to improve their symptoms. If prescribed medication is not effective in treating your HCM condition, septal myectomy surgery may be recommended by your care team.
Eligible candidates for septal myectomy most often include those with severe thickening of the heart muscle to their left heart ventricles or those diagnosed with HCM of varying symptoms who wish to become pregnant.
What Happens During a Septal Myectomy?
Patients undergoing septal myectomy at Penn Medicine will be provided expert pre- and post-surgical care through preparative appointments, day-of surgery navigation, and rehabilitation.
Preparation
Before scheduling the surgery, our cardiac specialists will guide you through what you need to do to prepare for your upcoming procedure. This will often include diet and other mild lifestyle limitations for a period of time prior to surgery. Certain medications, like blood thinners, may need to be stopped prior to surgery. Ask your cardiologist for guidance based on your personal needs.
You will also undergo certain cardiac tests to check your heart health prior to the procedure, such as chest X-rays, blood tests and echocardiograms.
Day of Surgery
Your cardiac surgeon performs septal myectomy in an operating suite. To begin, a cardiothoracic anesthesiologist administers general anesthesia to ensure you are resting comfortably throughout the procedure. Next, your surgeon:
- Makes a 6- to 8-inch incision through the breastbone (sternotomy) to provide visualization of and access to the heart.
- Connects you to a heart-lung machine (cardiopulmonary bypass). The machine takes over the function of your heart.
- Removes thickened muscle with specialized instruments.
- Performs additional procedures. If your mitral valve needs repair, your surgeon will perform this as well. Learn more about mitral valve surgery.
- Removes the heart-lung machine and closes the incision.
A septal myectomy procedure typically takes between three and four hours to complete.
Septal Myectomy Recovery and Cardiac Rehabilitation
After a myectomy, patients remain in the hospital for recovery for up to a week. Immediately following surgery, patients are moved to a post-anesthesia care unit (PACU) before being transferred to the intensive care unit (ICU). Critical care doctors and nurses will monitor you closely in the ICU, checking that the incision site is healing properly and heart levels are stable.
Your heart surgeon may recommend cardiac rehab to speed your recovery after surgery. Penn Medicine’s outpatient cardiac rehabilitation specialists provide gentle exercises, education and nutrition support to help you improve your stamina and quality of life.
Benefits and Risks of Septal Myectomy for HCM
Septal myectomy offers several advantages for those seeking treatment for HCM. Medication may not effectively treat the symptoms of HCM for some. Surgery offers a more durable solution to provide relief for people with severe symptoms, including:
- Chronic chest pain
- Fatigue
- Shortness of breath
- Swelling
- Fainting
- Pounding in the chest
While the risks of myectomy are low, it is important to be aware of the complications that may arise with any open-heart procedure. These may include:
- Infection
- Heart rhythm disruptions, such as heart block and heart arrhythmia
- Excess fluid around your heart or lungs
- Bleeding or blood clotting
Many of the complications of this procedure are associated with certain risk factors, like smoking, increased age, and the existence of other heart problems.
Alternatives to Septal Myectomy to Treat Hypertrophic Cardiomyopathy
For HCM patients who aren’t healthy enough to undergo open-heart surgery, your surgeon may recommend alcohol septal ablation. This less invasive procedure delivers benefit without the risk of surgery.
If HCM symptoms aren’t resolved with septal myectomy, Penn’s cardiac surgeons provide life-improving and lifesaving treatment options, including heart transplant. Our team delivers leading-edge care to thousands of people living with heart failure.
Learn more about the Penn Heart Failure Program
Septal Myectomy Surgical Care at Penn Medicine
When you come to Penn Medicine for your septal myectomy procedure, your care comes from cardiac surgery specialists that are among the top in the nation. More patients choose Penn for our:
- National endorsements: We are accredited by the Hypertrophic Cardiomyopathy Association, earning the Center of Excellence distinction.
- Surgical volume: As a regional referral center for HCM, we treat a large number of patients each year. This extensive surgical experience translates to excellent outcomes for our patients.
- Dedicated program: Our Center for Inherited Cardiovascular Diseases provides patients with exceptional care before and after septal myectomy.
- Genetic analysis: Our genetic counselors provide comprehensive genetic testing to family members of patients diagnosed with inherited hypertrophic cardiomyopathy.
Request an Appointment
To make an appointment, please call 800-789-7366 or request a callback.