Hypertrophic cardiomyopathy ( HCM) is the most common genetic cardiomyopathy. Septal myectomy ( SM) is the preferred approach for medication-refractory obstructive HCM. To assess the anatomical features of the structure of the left ventricle and mitral valve, and single-step assessment of coronary arteries patency and anatomy, when performing preoperative planning, we used computed tomography ( CT).

From April 2016 to April 2019, we reviewed studies of 198 patients who underwent preoperative CT scans prior to SM. Gated cardiac CT was performed in order to delineate the left ventricular (LV) myocardium, to assess the distribution of hypertrophy and the presence of crypts. Also, special attention was paid to the anatomy of the mitral valve and subvalvular apparatus. Patency of the coronary arteries was rated by Coronary Artery Disease - Reporting and Data System ( CAD-RADS).

Mean patient age was 47± 18 years, 42% were male. All the patients had symptomatic medication-refractory obstructive HCM. Mean maximal LV wall thickness was 19mm ( range 16-33) ( Fig.1). Preoperative mean peak LV outflow tract gradient was 80 mm Hg ( range 52 – 100). Mean postoperative LV outflow tract gradient was 15 mm Hg ( range 10-20). Mean LV mass index was 152±43g/m2. 39 patients had myocardial crypts ( Fig.2), 4 of which where in the surgical resection area. 179 patients had patent...

Gated cardiac CT can be a valuable addition to preoperative planning of patients with obstructive hypertrophic cardiomyopathy.

Dr. Mariia Tregubova Radiologist, Radiology Department, Amosov National Institute of Cardiovascular Surgery of National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine Email: [email protected] Dr. Rudenko Professor of Cardiac Surgery, Bohomolets National Medical University, Kyiv, Ukraine Email: [email protected] Dr. Fedkiv Head of Radiology Department, Amosov National Institute of Cardiovascular Surgery of National Academy of Medical Sciences of Ukraine, Kyiv, Ukarine Professor of Radiology, Shypuk National Medical Academy, Kyiv, Ukraine Email: [email protected]

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