Intraoperative Provocative Testing in Patients with Obstructive Hypertrophic Cardiomyopathy Undergoing Septal Myectomy

•In HCM, resting LVOT gradients on intraoperative TEE are lower than preoperative TTE. •Intraoperative pharmacologic provocation results in increased LVOT gradients. •Pharmacologic provocation overestimated gradients compared to preoperative values. •Uncovering latent pathology resulted in surgical revision for 14% of patients. Background Resolution of left ventricular outflow tract (LVOT) obstruction predicts symptom relief postmyectomy....