Robotic Trans-mitral Septal Myectomy with Mitral Repair for Asymmetric Ventricular Septal Hypertrophy with Systolic Mitral Anterior Leaflet Motion

Idiopatic hypertrophic subaortic stenosis (IHSS) is a type of obstructive cardiomyopathy that causes aortic outflow tract obstruction during systole. Moreover, the anterior leaflet can be shifted toward the hypertrophied septum creating, more outflow obstruction and concomitant mitral insufficiency. Traditional IHSS has been treated surgically through the aortic valve. In this chapter, we describe a robotic trans-atrial left approach to perform a large septal myectomy with concomitant mobilization of anterior papillary muscle and mitral valve reconstruction. Robotic methods provide ideal septal and valve exposure as well as superior visualization and ergonomic access.