OBJECTIVES This study examined: 1) the impact of myectomy on postoperative mitral regurgitation (MR) and 2) the association between the severity of MR and the left ventricular outflow tract (LVOT) gradient. BACKGROUND For patients with hypertrophic obstructive cardiomyopathy (HOCM) and MR, controversy exists as to whether myectomy alone is sufficient in eliminating MR. Furthermore, the relati...

An 18-year-old male patient, known with familial hypertrophic obstructive cardiomyopathy underwent a septal myectomy 10 years ago for significant left ventricular outflow tract (LVOT) obstruction. During follow-up a progressive increase in LVOT gradient was noted in association with severe mitral valve regurgitation. The patient underwent percutaneous alcohol septal ablation to induce regressio...

BACKGROUND Alcohol septal ablation (ASA) therapy results in clinical and hemodynamic improvement in patients with hypertrophic obstructive cardiomyopathy. However, a subset remains symptomatic afterward, requiring additional procedures. We sought to examine the determinants of an unsatisfactory outcome, defined as unchanged symptoms with <50% reduction of baseline left ventricular outflow tract...

OBJECTIVE We report the mid-term follow-up of patients, who underwent arterial switch operation (ASO) for transposition of the great arteries (TGA) with intact ventricular septum and left-ventricular outflow tract obstruction (LVOTO) over a 10-year period from 2000 to 2009. METHODS Thirteen TGA patients (3.9% of our ASO cohort) with intact ventricular septum and LVOTO underwent ASO. LVOTO was...

background: discrete subaortic stenosis (dss) is a progressive condition. controversy still rumbles on as to whether the subaortic membrane causes aortic regurgitation (ar) and whether membrane resection reduces ar severity. we investigated the association between the left ventricular outflow tract peak gradient (lvot-pg) and ar severity preoperatively and changes in ar severity and obstruction...

Systolic anterior motion (SAM) of the mitral valve or chordate is one characteristic seen in hypertrophic cardiomyopathy (HCM) either in obstructive or non-obstructive phenotypes. More often than not, the obstruction is caused by valvular rather than chordal SAM. We describe the role of echocardiography in identifying the actual anatomical location of the mitral valve apparatus involved in SAM ...

BACKGROUND Left ventricular outflow tract obstruction (LVOT) is an independent predictor of adverse outcome in hypertrophic cardiomyopathy (HCM). It is of major importance that the provocation modalities used are validated against each other. AIM To define the magnitude of LVOT gradients provocation during both isosorbide dinitrate (ISDN) inhalation and treadmill exercise in non-obstructive H...

BACKGROUND In patients with hypertrophic cardiomyopathy and left ventricular outflow tract (LVOT) obstruction, but without basal septal hypertrophy, we sought to identify mitral valve (MV) and papillary muscle (PM) abnormalities that predisposed to LVOT obstruction, using echo and cardiac magnetic resonance. METHODS AND RESULTS We studied 121 patients with hypertrophic cardiomyopathy hypertro...

AIMS Our purpose is to conduct a meta-analysis of all published studies comparing alcohol septal ablation (ASA) and myectomy (MM) for drug refractory hypertrophic obstructive cardiomyopathy (HOCM). Alcohol septal ablation is a less invasive alternative to MM for relief of symptoms in patients with drug refractory HOCM. METHODS AND RESULTS An extensive search of PubMed identified five non-rand...

Hypertrophic cardiomyopathy (HCM) has been associated with sudden death in young athletes. On long-term follow up, syncope, chest pain and dyspnea are well known frequent symptoms due to the dynamic left ventricular outflow tract (LVOT) obstruction, mitral regurgitation and diastolic dysfunction. To reduce the LVOT pressure gradient, septal myectomy and alcohol injection have recently been util...