title: A case report of surgical septal myectomy of hypertrophic cardiomyopathy with concomitant left ventricular outflow tract and mid-ventricular obstructions.
abstract: A 27-year-old female presented with dyspnea, fatigue, and exertional angina is found to have hypertrophic cardiomyopathy with marked hypertrophy of the papillary muscles, apex, septum, and lateral wall of the left ventricle. Also, small left ventricular cavity and systolic anterior movement of anterior mitral leaflet were observed at the echocardiography. The Doppler echocardiography revealed severe peak gradients at the left ventricle outflow tract (105 mmHg) and mid-ventricle (80 mmHg). At the operation, septal myectomy and anterior papillary muscle resection in addition to mitral valve replacement was performed. Surgical treatment gave an excellent clinical result. Control Doppler echocardiograms revealed no left ventricular outflow tract gradient, although mid-ventricular gradient was persistent. The good results were still present 18 months after the operation.
authors.affiliation: Cardiovascular Surgery Clinic, Yuzuncu Yil University, 65200 Van, Turkey. niyaziguler@hotmail.com
authors.forename: Niyazi
authors.initials: N
authors.lastname: Guler
authors.forename: Cenap
authors.initials: C
authors.lastname: Ozkara
authors.forename: Hasan Ali
authors.initials: HA
authors.lastname: Gumrukcuoglu
authors.forename: Hakki
authors.initials: H
authors.lastname: Simsek
mesh_terms: D000328:Adult; D006348:Cardiac Surgical Procedures; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D003937:Diagnosis, Differential; D017548:Echocardiography, Transesophageal; D005260:Female; D006346:Heart Septum / Q000601:surgery; D006801:Humans; D014694:Ventricular Outflow Obstruction / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*