Indications for Surgical Intervention in Patient with Hypertrophic Obstructive Cardiomyopathy

 

Criteria for considering a surgical intervention - all of the following:

(1) one or both of the following:

(1a) resting gradient in the left ventricular outflow tract > 30 mm Hg

(1b) gradient after provocative maneuver (Valsalva maneuver or exercise) > 50 mm Hg

(2) symptoms of dyspnea and/or angina that limit daily activity

(3) optimal medical therapy

(4) septal thickness >= 16 mm

 

Types of surgical procedures that can be performed:

(1) surgical septal myectomy

(2) catheter-based alcohol septal ablation

(3) dual chamber pacing