title: Hypertrophic angulation deformity of the basal interventricular septum combined with abnormality of the papillary muscle and chordae tendineae.
abstract: 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 connecting both basal interventricular septum and anterior leaflet of the mitral valve. All of these abnormalities resulted in a left ventricular outflow gradient of 136 mmHg. Surgical septal myectomy of the sharp angle combined with partial papillary muscle resection and removal of the abnormal chordae tendineae was selected to relieve the left ventricular outflow obstruction. This was a rare combination of deformity of the angulation of the focal basal interventricular septum and abnormalities of the papillary muscle and chordae tendineae, which led to left ventricular outflow obstruction.
authors.affiliation: Institute of Ultrasound Medicine, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu 610072, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Institute of Ultrasound Medicine, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu 610072, China.
authors.forename: Luwei
authors.initials: L
authors.lastname: Ye
authors.affiliation: Institute of Ultrasound Medicine, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu 610072, China.
authors.forename: Lixue
authors.initials: L
authors.lastname: Yin
authors.affiliation: Department of Cardiology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu 610072, China. Email: zengjie8302@126.com; zengjie999@sina.com.
authors.forename: Jie
authors.initials: J
authors.lastname: Zeng
mesh_terms: D000328:Adult; D006348:Cardiac Surgical Procedures / Q000379:methods; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D002815:Chordae Tendineae / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D004452:Echocardiography; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D010210:Papillary Muscles / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D014694:Ventricular Outflow Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D054088:Ventricular Septum / Q000000981:diagnostic imaging / Q000601:surgery*