I nfants with aortic arch obstruction and outlet ventricular septal defect can have posterior displacement of the infundibular septum into the left ventricular outflow tract causing varying degrees of subaortic stenosis.1-3 Because of the large ventricular septal defect, left ventricular outflow tract velocities are frequently normal. For this reason, Doppler peak gradients are often not helpfu...

We report the clinical case of a 77-years-old woman with cardiogenic shock caused by dynamic left ventricular outflow tract (LVOT) obstruction that appeared after anterior acute myocardial infarction. Dynamic LVOT obstruction has been reported in various circumstances aside from hypertrophic obstructive cardiomyopathy, such as acute myocardial infarction. In a patient with cardiogenic shock and...

The clinical, hemodynamic, and angiographic observations, as well as the surgical approach used for repair in three patients with congenitally corrected transposition of the great arteries and ventricular membranous septal aneurysms, are presented. In two of the three patients the membranous septal aneurysm caused subpulmonary obstruction, with 94 and 125 mm Hg systolic gradients. In each patie...

A 5-year-old boy was found to have a congenital left ventricular outflow tract (LVOT) aneurysm of the intervalvular fibrosa, LVOT obstruction after repair of a perimembranous ventricular septal defect, and aortic coarctation. The patient underwent successful plication of the aneurysm, resection of the fibrous subaortic stenosis, and septal myectomy.

The echocardiographic findings of eight patients with hypertrophic cardiomyopathy without outflow obstruction (HMC) and of 15 normal (Norm) individuals are presented. The characteristic features in HMC were: (1) interventricular septal width much greater than normal (HMC= 2.5 + 0.3 cm, Norm = 1.0 + 0.2 cm, P <0.005); (2) normal or only slightly increased posterior left ventricular wall thicknes...

A Chinese woman was admitted to our hospital because of syncope. Transthoracic echocardiography revealed a hypertrophic basal interventricular septum of 15 mm with a sharp angle protruding into the left ventricular outflow tract. Moreover, an anomalous anterolateral papillary muscle (maximum width of 11 mm) was inserted into the left ventricular outflow tract, with short chordae tendineae conne...

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...

BACKGROUND Hypertrophic cardiomyopathy (HCM) is a primary myocardial disease characterized by left ventricular hypertrophy in the absence of other etiologies. Clinical presentation may vary from asymptomatic to sudden cardiac death. Medical treatment is the first-line therapy for symptomatic patients. Extended left ventricular septal myectomy is the procedure of choice if medical treatment is u...

A 56-year-old man presented with breathlessness and chest pain. Echocardiography revealed 14-mm septal hypertrophy, complete systolic anterior motion of the anterior mitral valve leaflet, severe central mitral regurgitation, and a left ventricular outflow tract gradient of 40 mm Hg increasing to 56 mm Hg on Valsalva. A diagnosis of hypertrophic cardiomyopathy was made. Despite medical therapy, ...

Treatment of obstructive hypertrophic cardiomyopathy remains challenging. Medical therapy, surgical therapy, and pacemaker therapy have been shown to be beneficial in some patients over the years. Alcohol septal ablation is a catheter-based intervention that causes a controlled infarct in the septum leading to a decrease in the left ventricular outflow tract obstruction. Along with the impressi...