Transcatheter Myotomy for Hypertrophic Obstructive Cardiomyopathy

To describe the emerging role of transcatheter septal myotomy in the treatment of hypertrophic obstructive cardiomyopathy.

Transcatheter septal myotomy was developed to address risk of LVOT obstruction during TMVR, however it has been performed in patients with LVOT obstruction related to hypertrophic cardiomyopathy, in whom it improves symptoms, reduces LVOT gradients, and is associated with low incidence of procedural complications.

Transcatheter myotomy is a novel approach to address LVOT obstruction related to hypertrophic cardiomyopathy in patients who are not favorable surgical candidates. The risk of conduction abnormalities with transcatheter septal myotomy appears low. Research is needed to define optimal patient selection and long-term outcomes.