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ICD and angiography


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  • ICD and angiography

    Under what circumstances would someone be told to get an ICD but not a myectomy? Is that common?

  • #2
    Getting an ICD and a myectomy are two very different procedures for two different problems. The ICD is to protect you from potentially fatal arrhythmias, or dangerous heart rhythms. The myectomy is to reduce an obstruction caused by the thickening being literally in the way of your blood flow. The obstruction causes a gradient, or built up pressure, in the heart. The myectomy removes part of the heart muscle so the blood can flow and reduce the backflow pressure.


    Husband has HCM.
    3 kids - ages 23, 21, & 19. All presently clear of HCM.


    • #3
      I think that it is very common, because the two concepts aren't really related. The ICD is to prevent sudden death because the patient has more than one risk factor for sudden death and might have a lethal arrythmia. You would not have to be obstructed in order to qualify for an ICD.

      Conversely, a myectomy is offered only to those patients that have outflow tract obstruction. It removes the tissue that is blocking the outflow tract to ease the bloodflow into the aorta. It doesn't do anything to the electrical pathways in the heart which is what can go wacky and cause sudden death.

      Each thing has to be evaluated on its own merits. You could need one, both, or neither. It just depends on your situation.
      Daughter of Father with HCM
      Diagnosed with HCM 1999.
      Full term pregnancy - Son born 11/01
      ICD implanted 2/03; generator replaced 2/2005 and 2/2012
      Myectomy 8/11/06 - Joe Dearani - Mayo Clinic.