[Emergency myectomy in a patient with hypertrophic obstructive cardiomyopathy complicated with left heart failure and cardiac arrest].
Major cause of death in HOCM is sudden death due to ventricular arrhythmias, and only 10% of the death is caused by congestive heart failure. We report a 38-year-old woman of HOCM complicated with lung edema and cardiac arrest due to acute left heart failure. Intraventricular pressure gradient showed 125 mmHg in previous study, and echocardiogram demonstrated evidences suggestive of terminal-staged HOCM. After unsuccessful attempts of intravenous propranolol administration, emergency myectomy of left ventricular outflow tract was carried out. Postoperative course was uneventful, and intraventricular pressure gradient was relieved. The patient is now asymptomatic without medication after 1 years of operation. This case suggests that emergency myectomy may be a choice to relieve refractory congestive heart failure in patient with HOCM.
Abe
H
H
Third Department of Surgery, St. Marianna University School of Medicine, Kanagawa, Japan.
Kawada
T
T
Endo
S
S
Funaki
S
S
Okada
T
T
Yamate
N
N
D000328:Adult; D006348:Cardiac Surgical Procedures / Q000379:methods; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000601:surgery*; D004630:Emergencies; D005260:Female; D006323:Heart Arrest / Q000209:etiology / Q000601:surgery*; D006333:Heart Failure / Q000209:etiology / Q000601:surgery*; D006801:Humans