The case for surgery in obstructive hypertrophic cardiomyopathy
Barry J. Maron, MD, FACC*,*,
Joseph A. Dearani, MD ,
Steve R. Ommen, MD, FACC,
Martin S. Maron, MD ,
Hartzell V. Schaff, MD, FACC,
Bernard J. Gersh, MB, MBChB, DPhil, FACC and
Rick A. Nishimura, MD, FACC
* Hypertrophic Cardiomyopathy Center, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota
Departments of Cardiovascular Surgery and Cardiology, Mayo Clinic, Rochester, Minnesota
Hypertrophic Cardiomyopathy Center, Tufts-New England Medical Center, Boston, Massachusetts
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Figure 1 Presentation and treatment strategies for patient subgroups within the broad clinical spectrum of hypertrophic cardiomyopathy (HCM). AF = atrial fibrillation; DDD = dual-chamber; ICD = implantable cardioverter-defibrillator; MAZE = surgical procedure to abolish atrial fibrillation;PV = pulmonary vein; SD = sudden death; w/o = without. *No specific treatment or intervention indicated, except under exceptional circumstances. Adapted from Maron et al. (1) and reproduced with permission of the American College of Cardiology.
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Figure 2 Each of the individual factors which favor management decisions for respective therapeutic options in patients with obstructive hypertrophic cardiomyopathy and drug-refractory severe symptoms (New York Heart Association functional classes III/IV). LVH = left ventricular hypertrophy; MAZE = surgical procedure to abolish atrial fibrillation.
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