2.1 Patients
Between March 2016 and March 2019, consecutive HOCM patients aged ≥ 18
years who underwent septal myectomy with the aid of special surgical
instruments in this center were reviewed. Inclusion criteria were the
maximum LVOT gradients ≥ 50 mmHg at rest or with provocation and
presence of severe limiting symptoms refractory to maximum pharmacologic
therapy with non-vasodilating β-blockers and/or calcium channel
blockers. Exclusion criteria included: (1) organic mitral valve (MV)
lesions (rheumatic, degenerative, ischemic, infective, and mitral
annulus calcification); (2) previous valvular surgery; (3) LVOT
obstruction secondary to hypertensive heart disease or severe aortic
stenosis; (4) concomitant coronary artery disease requiring bypass
grafting; (5) concomitant modified Maze procedure; and (6) concomitant
obstruction of right ventricular outflow tract requiring enlargement.
Patients who underwent septal myectomy via the transseptal approach
through right atrium or via the left atrial approach through interatrial
sulcus were also excluded.