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Figure 1 Schematic Representation of the Differing Effects of Septal Reduction Therapies

Contrasting anatomical consequences of extended surgical septal myectomy shown in the short-axis plane (A) and alcohol septal ablation (B). (A) The tissue resected at myectomy is from the left ventricular side of the basal anterior septum. (B) The tissue necrosis resulting from alcohol ablation is usually transmural and located more posteriorly and inferiorly in the basal anterior septum than is the case for myectomy. At midventricular level (lower row of B), the tissue necrosis involves the inferior septum either with transmural distribution or predominantly the right ventricular portion of the septum.