Abstract
Surgical septal myectomy is the preferred treatment option for patients with medically intractable obstructive hypertrophic cardiomyopathy. Extended transaortic septal myectomy is a widely performed surgical procedure for patients with subaortic obstruction. The transapical approach may provide an alternative surgical option in less common phenotypes, such as apical hypertrophy or long-segmental septal hypertrophy. In this report, we describe a case of a procedure performed to achieve left ventricular enlargement procedure using a combined transaortic and transapical dual approach in a patient with diffuse-type hypertrophic cardiomyopathy with apical aneurysm and mid-cavity obstruction.