[A case of simultaneous treatment with mitral valve replacement and aorto-coronary bypass grafting of hypertrophic obstructive cardiomyopathy and coronary artery disease].
A case of surgical treatment of coexistent hypertrophic obstructive cardiomyopathy (HOCM) and coronary artery disease (CAD) in a 65-year-old male patient is reported. He had been diagnosed as HOCM and treated conservatively with beta-blocker and Ca-antagonist, but his complaints of chest oppression and palpitation had increased. Echocardiography revealed a systolic anterior motion of the mitral valve and mitral regurgitation. Cardiac catheterization showed a severe mitral regurgitation and peak systolic pressure gradient of 35 mmHg between the left ventricular and systemic artery. In addition, selective coronary angiography demonstrated a 99% stenosis in segment 7. He underwent aortocoronary bypass grafting and concomitant mitral valve replacement, and marked symptomatic and hemodynamic benefit could be achieved. This case shows the coexistence of HOCM and CAD in the same patient and suggest not only HOCM but also CAD should be routinely examined in the patient with angina, particularly when operative management is contempted. This case further suggests that simultaneous treatment of both diseases is more beneficial than single treatment of CAD or HOCM.
Noguchi
H
H
Second Department of Surgery, Fukui Medical School, Japan.
Doi
K
K
Ihaya
A
A
Chiba
Y
Y
Muraoka
R
R
D000368:Aged; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications*; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000150:complications / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000601:surgery; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000601:surgery*