Myectomie

Myectomie, or myectomy, is a surgical procedure involving the removal of all or part of a muscle. The aim is to reduce muscular bulk, weaken a muscle to change its function, relieve obstruction caused by muscular hypertrophy, or correct a deformity associated with abnormal contraction. The exact technique and indications vary by muscle and specialty.

In cardiac surgery, the term is most often used to describe a procedure to relieve left ventricular outflow tract obstruction in hypertrophic cardiomyopathy. Surgical myectomy typically removes part of the thickened interventricular septum, improving blood flow. It is performed under cardiopulmonary bypass and may reduce symptoms and the risk of heart failure.

In skeletal muscle, myectomy may treat severe contractures or focal hypertrophy causing functional impairment. It may be used with tendon release or lengthening and is chosen when removing part of a muscle is expected to improve movement while preserving nerve and blood supply.

Preoperative planning includes imaging, functional assessment, and localization of the target muscle. Depending on location, the operation is usually open but may be performed endoscopically or with minimally invasive techniques. Postoperative rehabilitation focuses on restoring range of motion and strength while preventing imbalance.

Risks include infection, bleeding, nerve or vessel injury, residual weakness, scarring, and recurrence of symptoms. Recovery varies by site and extent and often requires physical therapy and gradual return to activity. The term derives from Greek mys (muscle) and ektomē (excision).