Transapical Beating-Heart Septal Myectomy for Symptomatic Nonobstructive Hypertrophic Cardiomyopathy

Prior treatment

• Patients who had concomitant diseases such as intrinsic valvular disease or coronary artery disease that needed open-chamber cardiac surgery.

Lab values

• Patients who had severe heart failure with left ventricle ejection fraction \< 50%.

Other

• Patients who were pregnant.
• Patients whose estimated life expectancy \< 12 months.
• Patient who were non-compliant.
• peak VO2 of cardiopulmonary exercise test ≥ 90% of predicted.
• LVOT obstruction.
• Patients under circumstances which were considered not suitable or prohibitive for participating the clinical trial at the discretion of the attending medical team and the researchers.

• Patients who were diagnosed as nonobstructive hypertrophic cardiomyopathy, with maximal apical wall thickness ≥ 15 mm.
• Patients with heart function of New York Heart Association ≥ class II.
• Presenting with severe symptoms, e.g. angina, dyspnea, or fatigue, that were unresponsive or intolerant to pharmaceutical therapies;
• Kansas City Cardiomyopathy Questionnaire (KCCQ) score \< 80;
• Presenting with one of the following conditions: midventricular obstruction with gradient ≥ 50 mmHg; grade II or higher diastolic dysfunction; apical aneurysm; ventricular tachycardia that needed an ICD implantation; pulmonary hypertension.
• Patients who was informed the nature of the clinical trial, consented to participate in all of the activities of the clinical trial, and signed the informed consent form.