Illustration of the operative results. (A and B) Schematic representation of the traction exerted by fibrotic secondary MV chordae on the AML, and the results of resecting fibrotic secondary chordae (combined with a shallow myectomy) on the MV apparatus. (C and D) Pre-operative and post-operative echocardiographic images obtained in early systole in a patient with obstructive HCM and marked septal thickness, and (E and F) in a patient with obstructive HCM and mild septal thickness. Preoperatively, in both patients, fibrotic and retracted secondary AML chordae cause abnormal tethering of the AML with displacement of the MV valve apparatus towards the LV outflow tract (arrows). Postoperatively, the AML tethering is abolished (arrows), the MV apparatus has moved away from the LV outflow tract to a more posterior and normal position in the LV cavity. The MV tenting area is also substantially reduced.