Overview

This case-based webinar brings together an experienced structural heart team to explore the practical use of transcatheter electrosurgery in the SESAME technique for patients with challenging left ventricular outflow tract (LVOT) obstruction. Centred on stepwise, real‑world practice, the programme walks through when and how to use SESAME, from heart team decision‑making and imaging planning to intraprocedural execution and follow‑up.

Supported by emerging prospective and multicentre data, transcatheter electrosurgery and SESAME are evolving from early feasibility towards a viable option for carefully selected patients with LVOT obstruction who are often poor candidates for surgery. As this evidence base grows, it is increasingly important for structural heart teams to understand when and how to apply SESAME so they can offer advanced, less invasive solutions in contemporary structural programmes.

Moderated by Dr Nadira Hamid, the session opens with the clinical context and objectives of SESAME, setting the scene for a focused deep dive into technique and imaging. Dr Jaffar Khan will present “Open SESAME: Transcatheter Myotomy”, providing a structured overview of the SESAME concept and the latest supporting evidence.

Imaging forms a core component of the webinar. In “Imaging Essentials for SESAME”, Dr Omar Khalique will outline key pre‑procedural criteria, intraprocedural guidance strategies and follow‑up imaging to support safe, effective transcatheter myotomy. Building on this foundation, Dr Ignacio J. Amat‑Santos will address “Why SESAME and Best Practices?”, sharing experience‑based insights on patient selection, practical tips and strategies to optimise outcomes and avoid complications.

The programme then broadens to consider where SESAME sits in the wider treatment landscape. In “Best with Surgical Myomectomy”, Dr Francis Pagani will highlight scenarios where surgery remains the preferred option, providing a complementary surgical perspective on patient selection, outcomes and long‑term data. 

The session concludes with a panel discussion and live audience questions, allowing participants to address practical challenges, grey zones and implementation questions from their own programmes. 

Attendees will gain a clear, sequential understanding of SESAME, including how to integrate electrosurgical technique, imaging and team coordination to broaden treatment options for high‑risk patients with LVOT obstruction.