Thoracoscopic Transmitral Myectomy for an Anatomically Complex Case With Midventricular Obstruction.

A 51-year-old man was diagnosed with hypertrophic obstructive cardiomyopathy with left ventricular outflow tract obstruction at the subaortic and midventricular level combined with mitral systolic anterior motion and systolic anterior motion-related mitral regurgitation. The mildly thickened basal and nonthickened midventricular anteroseptum combined with the predominantly hypertrophic basal and midventricular inferoseptum made this case anatomically complex. Thoracoscopic transmitral myectomy plus fibrillation radiofrequency ablation were conducted to eliminate those lesions. The patient was discharged successfully and showed an improved hemodynamic and functional status at the 3-month follow-up.