Anomalous insertion of papillary muscle directly into anterior mitral leaflet in hypertrophic cardiomyopathy. Significance in producing left ventricular outflow obstruction.

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Anomalous Papillary Muscle Insertion Causing Dynamic Left Ventricular Outflow Tract Obstruction without Hypertrophic Obstructive Cardiomyopathy

Anomalous papillary muscle insertion directly into the surface of the mitral valve leaflet is rare, especially in a subject without apparent evidence of hypertrophic cardiomyopathy. We present a case of this isolated congenital malformation producing two hemodynamic sequelae of dynamic left ventricular outflow tract obstruction and severe mitral regurgitation.

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Pitfalls in clinical recognition and a novel operative approach for hypertrophic cardiomyopathy with severe outflow obstruction due to anomalous papillary muscle.

BACKGROUND Ventricular septal myotomy/myectomy (Morrow procedure) is the standard surgical option for severely symptomatic patients with hypertrophic cardiomyopathy (HCM) and marked basal obstruction to left ventricular outflow due to mitral valve systolic anterior motion. In some patients, however, congenital malformations of the mitral apparatus may be responsible for outflow obstruction; the...

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Left ventricular outflow tract obstruction due to anomalous insertion of papillary muscle.

A 56-year-old man who complained of quadrantic hemianopsia was admitted to determine its etiology. Cerebral angiography revealed no organic stenosis. Echocardiography showed clear direct continuity between a hypertrophied anterolateral papillary muscle and the anterior mitral leaflet, and the left ventricular (LV) outflow tract (LVOT) was narrowed by the presence of an accessory papillary muscl...

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Surgical management of left ventricular outflow obstruction in hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy is the single most common form of inherited heart disease. Left ventricular outflow tract obstruction (LVOTO) is a recognised feature of this condition which arises when blood leaving the outflow tract is impeded by systolic anterior motion of the mitral valve. In an important minority of patients, breathlessness, chest pain and syncope may result and persist despite...

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Left ventricular outflow obstruction induced by tamponade in hypertrophic cardiomyopathy.

Echocardiographic abnormalities of valvular movement described in patients with pericardial effusions have included systolic anterior motion (SAM) of the mitral valve. Published illustrations have shown, however, "pseudo-SAM" rather than true SAM. We report a patient with asymmetric septal hypertrophy whose echocardiogram during tamponade showed true SAM, which was no longer apparent and could ...

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ژورنال

عنوان ژورنال: Circulation

سال: 1991

ISSN: 0009-7322,1524-4539

DOI: 10.1161/01.cir.84.3.1188