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An unusual presentation of dyspnea following septal ablation for obstructive hypertrophic cardiomyopathy
Author(s) -
Ghoniem Khaled,
Nishimura Rick A.,
Schaff Hartzell V.
Publication year - 2021
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.15266
Subject(s) - medicine , alcohol septal ablation , cardiology , hypertrophic cardiomyopathy , constrictive pericarditis , pericardiectomy , septal myectomy , obstructive cardiomyopathy , ascending aorta , aorta , surgery
Residual or recurrent symptoms after septal reduction therapy are most often related to inadequate relief of left ventricular outflow gradients. We recently encountered a 71‐year‐old woman with hypertrophic cardiomyopathy and prior alcohol septal ablation who had a unique constellation of findings causing her symptoms. She was found to have four potential causes for her symptoms, residual midventricular obstruction, apical distribution of hypertrophy reducing end‐diastolic volume, constrictive pericarditis, and marked arterial stiffness, as reflected by aortic atherosclerosis. She underwent complete pericardiectomy, transaortic septal myectomy, transapical myectomy, and replacement of a heavily calcified ascending aorta.