Posterior mitral leaflet plication with extended septal myectomy for hypertrophic obstructive cardiomyopathy.

Abnormalities of the mitral valve apparatus are a phenotypical expression of hypertrophic cardiomyopathy and can contribute to systolic anterior motion and left ventricular outflow tract obstruction. In patients with significant abnormalities of the mitral apparatus, adjunct procedures like plication of the anterior mitral leaflet and/or release of papillary muscles may be required to obtain sufficient relief of obstruction. Very rarely, an elongated posterior mitral leaflet is the main culprit for systolic anterior motion. In such cases, plication of the posterior mitral leaflet is a useful technique, in addition to septal myectomy, to abolish left ventricular outflow tract obstruction. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12055-021-01213-1. © Indian Association of Cardiovascular-Thoracic Surgeons 2021.