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Hypertrophic Cardiomyopathy-Anesthesia Considerations for Septal Myectomy

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Abstract

Hypertrophic cardiomyopathy (HCM) is a non-dilated cardiomyopathy that occurs in the absence of a secondary cause. HCM is associated with atrial and ventricular arrhythmias, as well as left ventricular outflow tract (LVOT) obstruction and systolic anterior motion (SAM) of the mitral valve. When medical management is no longer sufficient in managing the symptoms of this disease, surgical management becomes necessary. Septal myectomy is the preferred intervention if that patient can tolerate the procedure. The procedure is performed through a median sternotomy with cardiopulmonary bypass. The hypertrophied septum is excised through different approaches depending on the exact location of the hypertrophy. Anesthetic management is geared towards minimizing sympathetic surges and avoiding both hypovolemia and tachycardia, as this will exacerbate the symptoms of LVOT and SAM. Transesophageal echocardiography (TEE) is essential in guiding the surgical procedure and evaluating for complications. As these patients tend to have few comorbidities, they are excellent candidates for early extubation.

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References

  1. Coats CJ, Hollman A. Hypertrophic cardiomyopathy: lessons from history. Heart. 2008;94(10):1258–63. https://doi.org/10.1136/hrt.2008.153452.

    Article  CAS  PubMed  Google Scholar 

  2. Teare D. Asymmetrical hypertrophy of the heart in young adults. Br Heart J. 1958;20(1):1–8.

    Article  CAS  Google Scholar 

  3. Braunwald E, Lambrew CT, Rockoff SD, Ross J, Morrow AG. Idiopathic hypertrophic subaortic stenosis: I. A description of the disease based upon an analysis of 64 patients. Circulation. 1964;30:3–119. https://doi.org/10.1161/01.CIR.29.5S4.IV-3.

    Article  Google Scholar 

  4. Maron BJ, Seidman CE, Ackerman MJ, et al. How should hypertrophic cardiomyopathy be classified? What’s in a name? Dilemmas in nomenclature characterizing hypertrophic Cardiomyopathy and left ventricular hypertrophy. Circ Cardiovasc Genet. 2009;2(1):81–6. https://doi.org/10.1161/CIRCGENETICS.108.788703.

    Article  PubMed  Google Scholar 

  5. Maron BJ, Ommen SR, Semsarian C, Spirito P, Olivotto I, Maron MS. Hypertrophic cardiomyopathy: Present and future, with translation into contemporary cardiovascular medicine. J Am Coll Cardiol. 2014;64(1):83–99. https://doi.org/10.1016/j.jacc.2014.05.003.

    Article  PubMed  Google Scholar 

  6. Semsarian C, Ingles J, Maron MS, Maron BJ. New perspectives on the prevalence of hypertrophic cardiomyopathy. J Am Coll Cardiol. 2015;65(12):1249–54. https://doi.org/10.1016/j.jacc.2015.01.019.

    Article  PubMed  Google Scholar 

  7. Maron BJ, Rowin EJ, Maron MS. Global burden of hypertrophic cardiomyopathy. JACC Heart Fail. 2018;6(5):376–8. https://doi.org/10.1016/j.jchf.2018.03.004.

    Article  PubMed  Google Scholar 

  8. Geisterfer-Lowrance AAT, Kass S, Tanigawa G, et al. A molecular basis for familial hypertrophic cardiomyopathy: a β cardiac myosin heavy chain gene missense mutation. Cell. 1990;62(5):999–1006. https://doi.org/10.1016/0092-8674(90)90274-I.

    Article  CAS  PubMed  Google Scholar 

  9. Burke MA, Cook SA, Seidman JG, Seidman CE. Clinical and mechanistic insights into the genetics of cardiomyopathy. J Am Coll Cardiol. 2016;68(25):2871–86. https://doi.org/10.1016/j.jacc.2016.08.079.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Maron BJ, Maron MS, Semsarian C. Genetics of hypertrophic cardiomyopathy after 20 years: clinical perspectives. J Am Coll Cardiol. 2012;60(8):705–15. https://doi.org/10.1016/j.jacc.2012.02.068.

    Article  PubMed  Google Scholar 

  11. Biagini E, Olivotto I, Iascone M, et al. Significance of sarcomere gene mutations analysis in the end-stage phase of hypertrophic cardiomyopathy. Am J Cardiol. 2014;114(5):769–76. https://doi.org/10.1016/j.amjcard.2014.05.065.

    Article  CAS  PubMed  Google Scholar 

  12. Maron BJ. Clinical course and management of hypertrophic cardiomyopathy. In: Longo DL, editor. N Engl J Med. 2018;379(7):655–68. https://doi.org/10.1056/NEJMra1710575.

    Article  PubMed  Google Scholar 

  13. Maron BJ, Maron MS. The remarkable 50 years of imaging in HCM and how it has changed diagnosis and management: from M-mode echocardiography to CMR. JACC Cardiovasc Imaging. 2016;9(7):858–72. https://doi.org/10.1016/j.jcmg.2016.05.003.

    Article  PubMed  Google Scholar 

  14. Maron MS, Hauser TH, Dubrow E, et al. Right ventricular involvement in hypertrophic cardiomyopathy. Am J Cardiol. 2007;100(8):1293–8. https://doi.org/10.1016/j.amjcard.2007.05.061.

    Article  PubMed  Google Scholar 

  15. Camici PG, Olivotto I, Rimoldi OE. The coronary circulation and blood flow in left ventricular hypertrophy. J Mol Cell Cardiol. 2012;52(4):857–64. https://doi.org/10.1016/j.yjmcc.2011.08.028.

    Article  CAS  PubMed  Google Scholar 

  16. Patten M, Pecha S, Aydin A. Atrial fibrillation in hypertrophic cardiomyopathy: diagnosis and considerations for management. J Atr Fibrillation. 2018;10(5):1556. https://doi.org/10.4022/jafib.1556.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Olivotto I, Cecchi F, Casey SA, Dolara A, Traverse JH, Maron BJ. Impact of atrial fibrillation on the clinical course of hypertrophic cardiomyopathy. Circulation. 2001;104(21):2517–24.

    Article  CAS  Google Scholar 

  18. Elliott PM, Anastasakis A, Borger MA, et al. 2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: the Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC). Eur Heart J. 2014;35(39):2733–79. https://doi.org/10.1093/eurheartj/ehu284.

    Article  PubMed  Google Scholar 

  19. Maron BJ, Doerer JJ, Haas TS, Tierney DM, Mueller FO. Sudden deaths in young competitive athletes: analysis of 1866 deaths in the United States, 1980–2006. Circulation. 2009;119(8):1085–92. https://doi.org/10.1161/CIRCULATIONAHA.108.804617.

    Article  PubMed  Google Scholar 

  20. Maron BJ, Maron MS, Lesser JR, et al. Sudden cardiac arrest in hypertrophic Cardiomyopathy in the absence of conventional criteria for high risk status. Am J Cardiol. 2008;101(4):544–7. https://doi.org/10.1016/j.amjcard.2007.09.101.

    Article  PubMed  Google Scholar 

  21. Maron BJ. Contemporary insights and strategies for risk stratification and prevention of sudden death in hypertrophic cardiomyopathy. Circulation. 2010;121(3):445–56. https://doi.org/10.1161/CIRCULATIONAHA.109.878579.

    Article  PubMed  Google Scholar 

  22. Chan RH, Maron BJ, Olivotto I, et al. Prognostic value of quantitative contrast-enhanced cardiovascular magnetic resonance for the evaluation of sudden death risk in patients with hypertrophic cardiomyopathy. Circulation. 2014;130(6):484–95. https://doi.org/10.1161/CIRCULATIONAHA.113.007094.

    Article  PubMed  Google Scholar 

  23. Moore B, Semsarian C, Chan KH, Sy RW. Sudden cardiac death and ventricular arrhythmias in hypertrophic cardiomyopathy. Heart Lung Circ. 2019;28(1):146–54. https://doi.org/10.1016/j.hlc.2018.07.019.

    Article  PubMed  Google Scholar 

  24. Schumacher B, Gietzen FH, Neuser H, et al. Electrophysiological characteristics of septal hypertrophy in patients with hypertrophic obstructive Cardiomyopathy and moderate to severe symptoms. Circulation. 2005;112(14):2096–101. https://doi.org/10.1161/CIRCULATIONAHA.104.515643.

    Article  PubMed  Google Scholar 

  25. Maron BJ, Rowin EJ, Casey SA, et al. Risk stratification and outcome of patients with hypertrophic cardiomyopathy ≥60 years of age. Circulation. 2013;127(5):585–93. https://doi.org/10.1161/CIRCULATIONAHA.112.136085.

    Article  PubMed  Google Scholar 

  26. Maron MS, Olivotto I, Harrigan C, et al. Mitral valve abnormalities identified by cardiovascular magnetic resonance represent a primary phenotypic expression of hypertrophic Cardiomyopathy. Circulation. 2011;124(1):40–7. https://doi.org/10.1161/CIRCULATIONAHA.110.985812.

    Article  CAS  PubMed  Google Scholar 

  27. Turer AT, Samad Z, Valente AM, et al. Anatomic and clinical correlates of septal morphology in hypertrophic cardiomyopathy. Eur J Echocardiogr. 2011;12(2):131–9. https://doi.org/10.1093/ejechocard/jeq163.

    Article  PubMed  Google Scholar 

  28. Henry WL, Clark CE, Griffith JM, Epstein SE. Mechanism of left ventricular outflow obstruction in patients with obstructive asymmetric septal hypertrophy (idiopathic hypertrophic subaortic stenosis). Am J Cardiol. 1975;35(3):337–45. https://doi.org/10.1016/0002-9149(75)90025-9.

    Article  CAS  PubMed  Google Scholar 

  29. Sherrid MV, Gunsburg DZ, Moldenhauer S, Pearle G. Systolic anterior motion begins at low left ventricular outflow tract velocity in obstructive hypertrophic cardiomyopathy. J Am Coll Cardiol. 2000;36(4):1344–54. https://doi.org/10.1016/S0735-1097(00)00830-5.

    Article  CAS  PubMed  Google Scholar 

  30. Shah PM, Kramer DAH, et al. Circulation. 1969;40:9.

    Article  Google Scholar 

  31. Maslow AD, Regan MM, Haering JM, Johnson RG, Levine RA. Echocardiographic predictors of left ventricular outflow tract obstruction and systolic anterior motion of the mitral valve after mitral valve reconstruction for myxomatous valve disease. J Am Coll Cardiol. 1999;34(7):2096–104. https://doi.org/10.1016/S0735-1097(99)00464-7.

    Article  CAS  PubMed  Google Scholar 

  32. Jiang L, Levine RA, King ME, Weyman AE. An integrated mechanism for systolic anterior motion of the mitral valve in hypertrophic cardiomyopathy based on echocardiographic observations. Am Heart J. 1987;113(3):633–44. https://doi.org/10.1016/0002-8703(87)90701-0.

    Article  CAS  PubMed  Google Scholar 

  33. Maron MS, Olivotto I, Zenovich AG, et al. Hypertrophic cardiomyopathy is predominantly a disease of left ventricular outflow tract obstruction. Circulation. 2006;114(21):2232–9. https://doi.org/10.1161/CIRCULATIONAHA.106.644682.

    Article  PubMed  Google Scholar 

  34. Gersh BJ, Maron BJ, Bonow RO, et al. 2011 ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2011;124(24):e783–831. https://doi.org/10.1161/CIR.0b013e318223e2bd.

    Article  Google Scholar 

  35. Maron MS, Olivotto I, Betocchi S, et al. Effect of left ventricular outflow tract obstruction on clinical outcome in hypertrophic cardiomyopathy. N Engl J Med. 2003;348(4):295–303. https://doi.org/10.1056/NEJMoa021332.

    Article  PubMed  Google Scholar 

  36. Maron BJ, Rowin EJ, Udelson JE, Maron MS. Clinical spectrum and management of heart failure in hypertrophic cardiomyopathy. JACC Heart Fail. 2018;6(5):353–63. https://doi.org/10.1016/j.jchf.2017.09.011.

    Article  PubMed  Google Scholar 

  37. Rowin EJ, Maron BJ, Abt P, et al. Impact of advanced therapies for improving survival to heart transplant in patients with hypertrophic Cardiomyopathy. Am J Cardiol. 2018;121(8):986–96. https://doi.org/10.1016/j.amjcard.2017.12.044.

    Article  PubMed  Google Scholar 

  38. Kaplan J. Kaplan’s cardiac anesthesia. 7th ed. Philadelphia, PA: Elsevier; 2017.

    Google Scholar 

  39. Solomon Z, Breton C, Rowin EJ, et al. Surgical approaches to hypertrophic obstructive Cardiomyopathy. Semin Thorac Cardiovasc Surg. 2018;30(2):125–8. https://doi.org/10.1053/j.semtcvs.2018.02.034.

    Article  PubMed  Google Scholar 

  40. Excision of anomalous muscle bundles as an important addition to extended septal myectomy for treatment of left ventricular outflow tract obstruction. Elsevier Enhanced Reader. https://doi.org/10.1016/j.jtcvs.2016.01.051

  41. Ommen SR, Maron BJ, Olivotto I, et al. Long-term effects of surgical septal myectomy on survival in patients with obstructive hypertrophic cardiomyopathy. J Am Coll Cardiol. 2005;46(3):470–6. https://doi.org/10.1016/j.jacc.2005.02.090.

    Article  PubMed  Google Scholar 

  42. McLeod CJ, Ommen SR, Ackerman MJ, et al. Surgical septal myectomy decreases the risk for appropriate implantable cardioverter defibrillator discharge in obstructive hypertrophic cardiomyopathy. Eur Heart J. 2007;28(21):2583–8. https://doi.org/10.1093/eurheartj/ehm117.

    Article  PubMed  Google Scholar 

  43. Maron BJ, Nishimura RA. Surgical septal myectomy versus alcohol septal ablation: assessing the status of the controversy in 2014. Circulation. 2014;130(18):1617–24. https://doi.org/10.1161/CIRCULATIONAHA.114.011580.

    Article  PubMed  Google Scholar 

  44. Alam M, Dokainish H, Lakkis NM. Hypertrophic obstructive cardiomyopathy-alcohol septal ablation vs. myectomy: a meta-analysis. Eur Heart J. 2009;30(9):1080–7. https://doi.org/10.1093/eurheartj/ehp016.

    Article  PubMed  Google Scholar 

  45. Kim LK, Swaminathan RV, Looser P, et al. Hospital volume outcomes after septal myectomy and alcohol septal ablation for treatment of obstructive hypertrophic cardiomyopathy: US nationwide inpatient database, 2003–2011. JAMA Cardiol. 2016;1(3):324–32. https://doi.org/10.1001/jamacardio.2016.0252.

    Article  PubMed  Google Scholar 

  46. Bonow RO, Yancy CW. Procedural volumes, outcomes, and quality in hypertrophic cardiomyopathy. JAMA Cardiol. 2016;1(3):334. https://doi.org/10.1001/jamacardio.2016.0711.

    Article  PubMed  Google Scholar 

  47. Ommen SR, Nishimura RA. Hypertrophic Cardiomyopathy—one case per year? A clarion call to do what is right. JAMA Cardiol. 2016;1(3):333–4. https://doi.org/10.1001/jamacardio.2016.0277.

    Article  PubMed  Google Scholar 

  48. Maron BJ, Maron MS. Hypertrophic cardiomyopathy. Lancet. 2013;381(9862):242–55. https://doi.org/10.1016/S0140-6736(12)60397-3.

    Article  PubMed  Google Scholar 

  49. Maron BJO. Hypertrophic cardiomyopathy. In: Braunwald’s heart disease: a textbook of cardiovascular medicine. 10th ed. Philadelphia, PA: Elsevier/Saunders; 2014.

    Google Scholar 

  50. Maron BJ, McKenna WJ, Danielson GK, et al. American College of Cardiology/European Society of Cardiology clinical expert consensus document on hypertrophic cardiomyopathy. A report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents and the European Society of Cardiology Committee for Practice Guidelines. J Am Coll Cardiol. 2003;42(9):1687–713. https://doi.org/10.1016/s0735-1097(03)00941-0.

    Article  PubMed  Google Scholar 

  51. Sigwart U. Non-surgical myocardial reduction for hypertrophic obstructive cardiomyopathy. Lancet. 1995;346(8969):211–4. https://doi.org/10.1016/s0140-6736(95)91267-3.

    Article  CAS  PubMed  Google Scholar 

  52. Alam M, Dokainish H, Lakkis N. Alcohol septal ablation for hypertrophic obstructive cardiomyopathy: a systematic review of published studies. J Interv Cardiol. 2006;19(4):319–27. https://doi.org/10.1111/j.1540-8183.2006.00153.x.

    Article  PubMed  Google Scholar 

  53. Said SM, Schaff HV. Surgical treatment of hypertrophic cardiomyopathy. Semin Thorac Cardiovasc Surg. 2013;25(4):300–9. https://doi.org/10.1053/j.semtcvs.2014.01.001.

    Article  PubMed  Google Scholar 

  54. Schaff HV, Said SM. Transaortic extended septal myectomy for hypertrophic cardiomyopathy. Oper Tech Thorac Cardiovasc Surg. 2012;17(4):238–50. https://doi.org/10.1053/j.optechstcvs.2012.04.002.

    Article  Google Scholar 

  55. Kunkala MR, Schaff HV, Nishimura RA, et al. Transapical approach to myectomy for midventricular obstruction in hypertrophic cardiomyopathy. Ann Thorac Surg. 2013;96(2):564–70. https://doi.org/10.1016/j.athoracsur.2013.04.073.

    Article  PubMed  Google Scholar 

  56. Ong KC, Geske JB, Schaff HV, Nishimura RA. Transapical myectomy for severe mid-ventricular obstructive hypertrophic cardiomyopathy. Eur Heart J. 2014;35(39):2713. https://doi.org/10.1093/eurheartj/ehu146.

    Article  PubMed  Google Scholar 

  57. Said SM, Schaff HV, Abel MD, Dearani JA. Transapical approach for apical myectomy and relief of midventricular obstruction in hypertrophic cardiomyopathy. J Card Surg. 2012;27(4):443–8. https://doi.org/10.1111/j.1540-8191.2012.01475.x.

    Article  PubMed  Google Scholar 

  58. Schaff HV, Brown ML, Dearani JA, et al. Apical myectomy: a new surgical technique for management of severely symptomatic patients with apical hypertrophic cardiomyopathy. J Thorac Cardiovasc Surg. 2010;139(3):634–40. https://doi.org/10.1016/j.jtcvs.2009.07.079.

    Article  PubMed  Google Scholar 

  59. ten Cate FJ, Soliman OII, Michels M, et al. Long-term outcome of alcohol septal ablation in patients with obstructive hypertrophic cardiomyopathy: a word of caution. Circ Heart Fail. 2010;3(3):362–9. https://doi.org/10.1161/CIRCHEARTFAILURE.109.862359.

    Article  PubMed  Google Scholar 

  60. Valeti US, Nishimura RA, Holmes DR, et al. Comparison of surgical septal myectomy and alcohol septal ablation with cardiac magnetic resonance imaging in patients with hypertrophic obstructive cardiomyopathy. J Am Coll Cardiol. 2007;49(3):350–7. https://doi.org/10.1016/j.jacc.2006.08.055.

    Article  PubMed  Google Scholar 

  61. Maron BJ. Is septal ablation preferable to surgical myomectomy for obstructive hypertrophic cardiomyopathy? Circulation. 2007;116:196. https://doi.org/10.1161/CIRCULATIONAHA.107.691378.

    Article  PubMed  Google Scholar 

  62. Liebregts M, Vriesendorp PA, Mahmoodi BK, Schinkel AFL, Michels M, ten Berg JM. A systematic review and meta-analysis of long-term outcomes after septal reduction therapy in patients with hypertrophic cardiomyopathy. JACC Heart Fail. 2015;3(11):896–905. https://doi.org/10.1016/j.jchf.2015.06.011.

    Article  PubMed  Google Scholar 

  63. Sorajja P, Ommen SR, Holmes DR, et al. Survival after alcohol septal ablation for obstructive hypertrophic cardiomyopathy. Circulation. 2012;126(20):2374–80. https://doi.org/10.1161/CIRCULATIONAHA.111.076257.

    Article  PubMed  Google Scholar 

  64. Vriesendorp PA, Liebregts M, Steggerda RC, et al. Long-term outcomes after medical and invasive treatment in patients with hypertrophic cardiomyopathy. JACC Heart Fail. 2014;2(6):630–6. https://doi.org/10.1016/j.jchf.2014.06.012.

    Article  PubMed  Google Scholar 

  65. Steggerda RC, Damman K, Balt JC, Liebregts M, ten Berg JM, van den Berg MP. Periprocedural complications and long-term outcome after alcohol septal ablation versus surgical myectomy in hypertrophic obstructive cardiomyopathy: a single-center experience. JACC Cardiovasc Interv. 2014;7(11):1227–34. https://doi.org/10.1016/j.jcin.2014.05.023.

    Article  PubMed  Google Scholar 

  66. Nguyen A, Schaff HV, Hang D, et al. Surgical myectomy versus alcohol septal ablation for obstructive hypertrophic cardiomyopathy: a propensity score–matched cohort. J Thorac Cardiovasc Surg. 2019;157(1):306–315.e3. https://doi.org/10.1016/j.jtcvs.2018.08.062.

    Article  PubMed  Google Scholar 

  67. Kimmelstiel C, Zisa DC, Kuttab JS, et al. Guideline-based referral for septal reduction therapy in obstructive hypertrophic cardiomyopathy is associated with excellent clinical outcomes. Circ Cardiovasc Interv. 2019;12(7):e007673. https://doi.org/10.1161/CIRCINTERVENTIONS.118.007673.

    Article  PubMed  PubMed Central  Google Scholar 

  68. American College of Cardiology/European Society of Cardiology Clinical Expert Consensus Document on Hypertrophic cardiomyopathy. Elsevier Enhanced Reader. https://doi.org/10.1016/S0735-1097(03)00941-0

  69. Klues HG, Schiffers A, Maron BJ. Phenotypic spectrum and patterns of left ventricular hypertrophy in hypertrophic cardiomyopathy: morphologic observations and significance as assessed by two-dimensional echocardiography in 600 patients. J Am Coll Cardiol. 1995;26(7):1699–708. https://doi.org/10.1016/0735-1097(95)00390-8.

    Article  CAS  PubMed  Google Scholar 

  70. Maron MS, Maron BJ, Harrigan C, et al. Hypertrophic cardiomyopathy phenotype revisited after 50 years with cardiovascular magnetic resonance. J Am Coll Cardiol. 2009;54(3):220–8. https://doi.org/10.1016/j.jacc.2009.05.006.

    Article  PubMed  Google Scholar 

  71. Maron BJ, Spirito P, Shen W-K, et al. Implantable cardioverter-defibrillators and prevention of sudden cardiac death in hypertrophic cardiomyopathy. JAMA. 2007;298(4):405–12. https://doi.org/10.1001/jama.298.4.405.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Thomas Jefferson University, Philadelphia, PA, USA

    Regina E. Linganna, Ron L. Leong & Eric T. Feduska

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  1. Regina E. Linganna
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  2. Ron L. Leong
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  1. Perelman School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA

    Basavana G. Goudra

  2. Department of Anesthesiology, Washington University in Saint Louis, St. Louis, MO, USA

    Preet Mohinder Singh

  3. Department of Anesthesiology, Thomas Jefferson University Hospital, Philadelphia, PA, USA

    Michael S. Green

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Linganna, R.E., Leong, R.L., Feduska, E.T. (2021). Hypertrophic Cardiomyopathy-Anesthesia Considerations for Septal Myectomy. In: Goudra, B.G., Singh, P.M., Green, M.S. (eds) Anaesthesia for Uncommon and Emerging Procedures . Springer, Cham. https://doi.org/10.1007/978-3-030-64739-1_24

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