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.1-3 While 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.4 Reports 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 associates5 demonstrated that satisfactory exposure of mitral valve structures could be achieved through a fish-mouth apical left ventriculotomy, and the clinical experiences of Julian et al6 and Taber and Green7 showed that this incision
Replogle RL, Kundler H, Gross RE. Left Ventricular Performance Following Apical Left Ventriculotomy. Arch Surg. 1967;95(6):892-897. doi:10.1001/archsurg.1967.01330180040007