myectomies

Myectomy is a surgical procedure in which all or part of a muscle is removed. The goal is to reduce muscle mass, weaken a muscle that obstructs or impairs function, or correct a deformity. Myectomy differs from myotomy, which involves cutting through a muscle without removing tissue, and from myoplasty, which repairs or reconstructs muscle.

In cardiac surgery, a cardiac myectomy is used to treat hypertrophic obstructive cardiomyopathy. It removes part of the thickened interventricular septum to widen the left ventricular outflow tract and relieve obstruction. The operation is usually performed through a sternotomy with cardiopulmonary bypass and may be combined with procedures on the mitral valve. Outcomes typically include symptom relief and reduced left ventricular outflow tract gradients, with improvements in exercise capacity. Risks include heart block requiring a pacemaker, arrhythmias, bleeding, infection, and stroke.

In ophthalmology, myectomy of extraocular muscles is a permitted method for weakening an overacting muscle in select cases of strabismus. It is less commonly used than recession or resection but may be chosen when anatomical considerations or rapid weakening are advantageous. Potential drawbacks include under- or overcorrection, scar formation, and limited ability to adjust after the procedure.

Outside the heart and eye, myectomies are relatively uncommon and largely described in case reports or specialized surgical contexts. They may be explored in research on muscle function or used to address localized muscular hypertrophy, but such applications require careful patient selection and multidisciplinary planning.