Robotic Mitral Valve Surgery With Intracardiac Ultrasound-Guided Septal Myectomy.

Hypertrophic obstructive cardiomyopathy requires surgical myectomy when heart failure symptoms persist despite best medical therapy. Minimally invasive myectomy with robotic surgery can be performed in experienced centers, allowing for surgical correction of accompanying mitral valve pathologies. The extent of myectomy is important to relieve left ventricular outflow tract obstruction while care should be taken to prevent iatrogenic ventricular septal defects or heart blocks caused by excessive removal of septal tissue. We report the use of intracardiac ultrasonography during robotic surgery to intraoperatively assess the myocardium before and after myectomy to increase the safety of this procedure.