PMC:3567831 / 6051-7370 JSONTXT

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Through a transverse aortotomy, the aortic valve was exposed totally after cardiac asystole induced with cold blood cardioplegia. The aortic leaflets were retracted by the assistant so as to inspect the LVOT, the hypertrophic cardiac muscle and anterior mitral valve leaflet. For better exposure through the aortic incision, we used two long retractors and a suction pump that could suck the blood in the LV and retract the aortic valve simultaneously (Figs 1–3). It is also important for the surgeon to have a head lamp. Moreover, it is usually necessary to use a medical gauze ball as a depressor to press the hypertrophic muscle from outside the heart, so better exposure can be gained and resection carried out more easily. Additionally, two homemade long-handled scalpels (one sharp, the other bush-hook) with a length of ∼30 cm and a long pair of surgical forceps (∼32 cm long) were used during the resection.\nFigure 1: Abnormal muscle located between the anterior papillary muscle and the anterior leaflet of the mitral valve.\nFigure 2: The abnormal muscle bundle was cut off.\nFigure 3: Hypertrophic IVS was partially resected."}