The relation between left atrial size and atrial fibrillation was examined in 37 patients who had left ventriculomyotomy and myectomy at the National Heart and Lung Institute. Atrial fibrillation was present in 11 of 27 (41%) patients with an echocardiographically measured left atrial dimension greater than 45 mm. No patient with a left atrial dimension less than 45 mm had atrial fibrillation p...

Cases of iatrogenic coronary artery fistulas draining into the left ventricle after surgical myectomy for hypertrophic obstructive cardiomyopathy have been published as sporadic reports. However, its management scheme and prognosis are not clear because of the low incidence. A 46-yr-old woman was hospitalized for evaluation of chest pain and shortness of breath for 3 months. Transthoracic echoc...

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...

Septal hyper-contractility is thought to be the principal cause of significant left ventricular outflow tract obstruction (LVOT) and systolic anterior motion (SAM) of the mitral valve by making the distance between the mitral valve and papillary muscle shorter. A seven-year-old patient with severe hypertrophic obstructive cardiomyopathy underwent direct interventricular septal myectomy/myotomy ...

PURPOSE To introduce myectomy of the lateral rectus muscle for correcting exotropia in patients with third nerve palsy. METHODS The lateral rectus muscle of the paretic eye was myectomized without suturing it to the globe. This was combined with a medial rectus muscle resection and a contralateral lateral rectus muscle recession. Magnetic resonance imaging was performed to observe the re-atta...

It has been 18 years since the first alcohol septal ablation was performed in London for relief of symptoms associated with left ventricular outflow tract obstruction in hypertrophic obstructive cardiomyopathy. In the interval since the introduction of this catheter-based alternative to surgical myectomy, use of this procedure has disseminated across the globe, and numerous reports have been pu...

An 18-year-old male patient, known with familial hypertrophic obstructive cardiomyopathy underwent a septal myectomy 10 years ago for significant left ventricular outflow tract (LVOT) obstruction. During follow-up a progressive increase in LVOT gradient was noted in association with severe mitral valve regurgitation. The patient underwent percutaneous alcohol septal ablation to induce regressio...

INTRODUCTION Hypertrophic cardiomyopathy is a genetic cardiac disease characterized by marked variability in morphological expression and natural history. The hypertrophic myocardium is often confined to the septum or lateral wall of the left ventricle, but it can also be encountered in the middle or apical segments of the myocardium. Treatment is based on medical therapy. Others therapies, suc...

1617 I n hypertrophic cardiomyopathy (HCM), left ventricular (LV) outflow tract obstruction, caused by mitral valve sys-tolic anterior motion (SAM) with elevated intracavitary LV pressures, can produce disabling symptoms of heart failure and excess cardiovascular mortality. Outflow gradients are common in HCM, present in 70% of patients at rest or with physiological exercise 4 (Figure 1). Fifty...