What is a septal myectomy?
A septal myectomy is a surgical heart procedure used to treat hypertrophic cardiomyopathy when medication is not effective in reducing the thickening in the heart muscle.
If you are a candidate, your Mercy Health cardiothoracic surgeon will remove a small portion of the affected septal wall to widen the opening from the left ventricle to the aorta.
Most patients have significant symptom improvement and improved quality of life after surgery.
Who is a candidate for a septal myectomy?
If you have been diagnosed with severe hypertrophic cardiomyopathy or have severe obstruction, your doctor will evaluate your condition to determine if you are a candidate for septal myectomy. Most patients with hypertrophic cardiomyopathy have obstruction related to the condition.
Patients who don’t have many symptoms may be treated with medications such as beta blockers or calcium channel blockers.
What to expect during a septal myectomy
A septal myectomy procedure takes three to six hours to perform. In preparation for the procedure, your doctor will give you general anesthesia, so you’ll go to sleep and won’t feel the procedure.
During the septal myectomy, your surgeon will make a large incision (6 to 8 inches) down your chest to separate your breastbone and connect you to a heart-lung machine. The heart-lung machine will provide oxygen to the blood as well as pump your blood for your heart during the procedure. When in the proper position, your surgeon will cut the thickened part of the septum.
When the surgeon is finished, he or she will remove the heart-lung machine, connect your breast bones back together and close the incision sites.
Risks of a septal myectomy
Although a septal myectomy is relatively safe, complications can occur.
Complications may include:
- Heart attack
- Stroke
- Severe bleeding
- Arrhythmias
- Aortic valve abnormalities
If you are obese, older age, have chronic heart, lung or other illnesses, you are more likely to suffer from complications associated with a septal myectomy.
Recovery from a septal myectomy
After surgery, your cardiac team will transfer you to the intensive care unit (ICU) for monitoring for up to two days after surgery. Your Mercy Health team will monitor your vital signs, including blood pressure, oxygen checks and heart sounds to check for any abnormalities.
When you are deemed ready, your care team will transfer you to a regular hospital room where you will stay as long as a week more. You may need cardiac rehab to aid in your recovery.
Some patients may need other treatments such as an implantable cardioverter-defibrillator to help treat cardiac arrhythmias.
Most patients require six to eight weeks recovery time to get back to normal activities. You will not be able to drive until your doctor gives you clearance — typically three to eight weeks.
Your Mercy Health cardiac team will provide you with a schedule of follow-up visits. Even if you are not experiencing symptoms, it is important to follow your appointment schedule.
Your doctor may also give you a list of lifestyle modifications you can make to help your heart heal.
Modifications could include:
- Eating a heart healthy diet
- Exercising
- Quitting smoking
- Treat cholesterol
- Control stress or anger
- Manage high blood pressure or high cholesterol