We read with interest the article by Aggarwal et al.  about the intraoperative echocardiography detection of abnormal mitral valve apparatus in a patient scheduled for surgery for hypertrophic obstructive cardiomyopathy in the latest issue of Annals. The authors need to be congratulated for detecting the various abnormalities of the mitral valve apparatus by intraoperative transesophageal echocardiography; however, we feel that the concomitant mitral valve replacement along with septal myectomy was probably unwarranted.
Dr. Praveen Varma and Ahamed, H., “Abnormal mitral valve apparatus is not an indication for mitral valve replacement in hypertrophic obstructive cardiomyopathy”, Annals of Cardiac Anaesthesia, vol. 23, no. 2, pp. 246-247, 2020.