A myomectomy may be recommended if you have hypertrophic cardiomyopathy (HCM) with obstruction to the blood leaving your heart, and your medication is not controlling your symptoms. With this procedure, part of the enlarged septal muscle causing the obstruction is shaved away. A myomectomy usually involves open heart surgery, although it can now also be carried out by approaching the heart through the aorta and destroying the enlarged bit of septal muscle by injecting alcohol into the blood vessels that supply it. Removing this enlarged muscle will allow blood to flow more easily to the aorta and rest of your body, therefore reducing your symptoms.