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The primary surgical approaches to hypertrophic cardiomyopathy are transaortic septal myectomy alone or with mitral valve replacement. Surgery is usually reserved for patients with fixed or dynamic out- flow tract obstruction and refrac- tory NYHA class III or IV angina or heart failure. This retrospective study reviews the early and late outcomes of patients under surg- ical management for obstructive hypertrophy at the Cleveland Clinic.
A consecutive series of 178 patients underwent surgery for angina, syncope, heart failure, or arrhythmia; operations included septal myectomy alone (54%); myectomy and CABG (23%) or valve replacement (14%); combined myectomy, CABG, and valve surgery (8%); and mitral valve replacement alone (2%).
The mean max…