Extended myectomy for hypertrophic obstructive cardiomyopathy.

An extended surgical technique for better relief of the obstruction as well as of mitral valve incompetence in patients with hypertrophic obstructive cardiomyopathy is presented. In addition to the traditional septal myectomy facilitated by insertion of a sharp triple-hook retractor, operation is extended to the hypertrophied and mal-attached papillary muscles primarily responsible for the systolic anterior motion and mitral insufficiency, respectively. Long-term results confirm the accuracy of our operative strategy.