The authors report the case of a 60-year-old patient with hypertrophic cardiomyopathy (HCM), systolic anterior motion (SAM), and high gradient in the left ventricular outflow tract (LVOT) who underwent surgical treatment. During the surgery, myomectomy of the septum was performed using the Morrow method: despite the persisting SAM and increased LVOT gradients, the mitral valve was not replaced....

Background Patients with hypertrophic cardiomyopathy (HCM) develop left ventricular outflow tract (LVOT) obstruction due to combination of asymmetric septal hypertrophy and systolic anterior motion of the mitral leaflet. Degree of LVOT obstruction is an important predictor in patient symptoms and clinical outcome. LVOT obstruction is currently assessed by Doppler echocardiography (echo) using p...

BACKGROUND A hyperdynamic state of the basal left ventricle sometimes results in obstruction of the left ventricular outflow tract (LVOT). However, the prevalence, clinical presentation, and prognostic effect of LVOT obstruction in takotsubo cardiomyopathy (TC) have not been fully evaluated. METHODS AND RESULTS Among 933 consecutive patients who underwent emergency coronary angiography for su...

BACKGROUND Transcatheter pulmonary valve replacement (TPVR) is an established therapy for dysfunctional right ventricular (RV) outflow tract conduits. TPVR in patients with congenitally corrected transposition of the great arteries, subpulmonary left ventricle, and left ventricular outflow tract (LVOT) conduit dysfunction has not been studied. Unique anatomic and physiological aspects of this p...

Background—Analyzing the determinants of systolic anterior motion of the mitral valve and consequent left ventricular outflow tract (LVOT) obstruction in patients with asymmetrical septal hypertrophy requires a comprehensive 3-dimensional analysis of mitral leaflet (ML) area, papillary muscle (PM) geometry, and the distribution of left ventricular hypertrophy. Methods and Results—Real-time 3-di...

AIMS Discrete subaortic stenosis (DSS) is often diagnosed early in life and known for its sometimes rapid haemodynamic progression in childhood and strong association with aortic regurgitation (AR). However, data about the evolution of DSS in adulthood are scarce. Therefore, we aimed to evaluate the natural history of DSS, and identify risk factors for the progression of DSS, AR, and interventi...

The Brockenbrough–Braunwald–Morrow sign was first described in 1961 (1) in individuals with hypertrophic cardiomyopathy and dynamic left ventricular (LV) outflow tract (LVOT) obstruction worsened by conditions associated with increased myocardial contractility. The sign was characterized by an increase in peak-systolic gradient combined with a decrease in pulse pressure after an extrasystolic b...

BACKGROUND Analyzing the determinants of systolic anterior motion of the mitral valve and consequent left ventricular outflow tract (LVOT) obstruction in patients with asymmetrical septal hypertrophy requires a comprehensive 3-dimensional analysis of mitral leaflet (ML) area, papillary muscle (PM) geometry, and the distribution of left ventricular hypertrophy. METHODS AND RESULTS Real-time 3-...

Hypertrophic cardiomyopathy (HCM) is an inherited disease of the heart muscle characterized by otherwise unexplained thickening of the left ventricle. Left ventricular outflow tract (LVOT) obstruction is present in approximately two-thirds of patients and substantially increases the risk of disease complications. Invasive treatment with septal myectomy or alcohol septal ablation can improve sym...