Left Ventricular Performance Following Apical Left Ventriculotomy

ADEQUATE exposure of the left ventricular area immediately beneath the aortic valve for the surgical correction of hypertrophic muscular subaortic stenosis may be quite difficult.¹⁻³While satisfactory results have been achieved with a semiblind approach, the danger of injury to the anterior leaflet of the mitral valve or the left branch of the bundle of His would seem to make this technique hazardous.⁴Reports of various methods of achieving better visualization of this area are numerous, and unquestionably, many of them are quite satisfactory. However, there are disadvantages to each and proper selection of the best method depends upon which is the simplest and safest. The experimental work of Hirose and associates⁵demonstrated that satisfactory exposure of mitral valve structures could be achieved through a fish-mouth apical left ventriculotomy, and the clinical experiences of Julian et al⁶and Taber and Green⁷showed that this incision