Preoperative simulation using ct virtual endoscopy for minimally invasive surgery of hypertrophic obstructive cardiomyopathy

Abstract

Transaortic septal myectomy is a procedure that involves a learning curve for surgeons because the bulging interventricular septum usually interferes with the visualization of the deep parts of the left ventricular chamber. In this case report, we demonstrate computed tomography virtual endoscopy for preoperative simulation, which enabled us to clearly image the relationship among the bulging septum, the expected myectomy area, and the structures deep in the left ventricle, such as the papillary muscle and abnormal muscular bundles, which are hidden by the hypertrophic septum, thus preventing visualization. This approach could make minimally invasive transaortic septal myectomy safe and easy.