Surgical options are limited for children with cardiomyopathy; it is primarily used to alleviate more serious symptoms. At this point, surgery cannot repair the damaged heart or stop the progression of the disease. Some children with hypertrophic cardiomyopathy develop a severe thickening of the heart muscle, which blocks the blood flow out of the lower chambers of the heart (ventricle). For an older child, a septal myectomy may be recommended to reduce the thickness of the heart muscle. Children with dilated cardiomyopathy may need surgery to repair or replace a leaky mitral valve that is affecting their heart function.
There is no surgery for improving heart function in other forms of cardiomyopathy. A heart transplant may be considered for children with severe heart failure and who have not responded to medication.
Septal myectomy is a surgical procedure that may be recommended for patients with hypertrophic obstructive cardiomyopathy who have developed symptoms of heart failure. The surgery reduces obstruction by removing excessive heart muscle tissue that may be blocking the blood flow out of the heart.
While septal myectomy is effective in controlling severe symptoms, it does not stop the disease from progressing nor does it correct abnormal heart rhythms. Septal myectomy is considered open-heart surgery with a complication rate that is higher in small children compared to adults. It involves recovery time both in the hospital and at home.
Alcohol septal ablation is an alternative procedure to surgery commonly recommended for adults with hypertrophic obstructive cardiomyopathy. Although, it is a less invasive procedure, it generally is not recommended for young children because of their smaller heart size and narrower blood vessels.
Mitral Valve Repair or Replacement
In some patients with dilated or hypertrophic cardiomyopathy, the function of the mitral valve, which connects the left upper heart chamber (atrium) to the left lower heart chamber (ventricle), can be affected by the heart’s enlargement. Leakage may occur between the heart chambers (mitral regurgitation), causing the heart to pump less efficiently. Mitral valve repair or replacement through open heart surgery can improve the function of the heart muscle and lessen the symptoms of heart failure.