Browse
Submit Data
Databases
API
Help

Dataset Information

47 Views

0 Connections

0 Citations

0 Reanalyses

0 Downloads

Omics score: 0

Haemodynamic Interplay Between Concomitant Left Ventricular Outflow Tract Obstruction and Aortic Stenosis.

ABSTRACT: The authors describe a patient with hypertrophic cardiomyopathy with concomitant left ventricular outflow tract obstruction and aortic stenosis. Detailed haemodynamic assessment of the serial lesions was performed. Alcohol septal ablation resulted in a significant reduction of gradients across the left ventricular outflow tract.

SUBMITTER: Bansal P

PROVIDER: S-EPMC8239956 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Json Xml

Similar Datasets

Isolated sub-aortic obstruction - A cause of left ventricular outflow tract obstruction.

Project description: Not available

| S-EPMC10231731 | biostudies-literature

Dynamic Left Ventricular Outflow Tract Obstruction Post-Transcatheter Aortic Valve Replacement.

Project description:We describe the first case of successful management of left ventricular outflow tract obstruction developing late after transcatheter aortic valve replacement with right ventricular apical pacing. The possible mechanisms of obstruction resolution are described. (Level of Difficulty: Advanced.).

| S-EPMC8311343 | biostudies-literature

Unmasking the severity of aortic stenosis by pharmacological elimination of left ventricular outflow tract obstruction: a case report.

Project description:BackgroundLeft ventricular outflow tract (LVOT) obstruction may occur with aortic stenosis (AS). However, the severity of AS is difficult to determine in this condition because the dynamic pressure gradient in LVOT obstruction influences the blood flow across the aortic valve.Case summaryA 74-year-old woman was referred to our hospital having complaints of exertional dyspnoea and chest pain. Transthoracic echocardiography demonstrated LVOT obstruction with peak pressure gradient of 93 mmHg and 'moderate' AS with 3.9 m/s peak velocity and mean pressure gradient of 26 mmHg. Coronary angiography did not indicate any significant coronary artery disease. The pressure gradients at LVOT and aortic valve were measured as 34 mmHg and 76 mmHg via a pressure wire-pullback analysis, respectively. Intravenous 2 mg propranolol and 70 mg cibenzoline were administered to minimize the LVOT obstruction. Subsequently, these pressure gradients changed to 2 mmHg and 96 mmHg, respectively. The patient was finally diagnosed with 'severe' AS concomitant with LVOT obstruction. Therefore, surgical aortic valve replacement and myectomy were performed to remove the double obstruction.DiscussionHerein, we present a case of 'double' LVOT obstruction due to dynamic myocardial component and fixed aortic component. Although the severity of AS is known to be influenced by LVOT obstruction, the present case is novel to demonstrate the phenomenon by using a pressure wire during pharmacological intervention. An accurate evaluation of the AS severity is important to provide adequate treatment. Therefore, the severity of AS should be evaluated while minimizing the LVOT obstruction.

| S-EPMC10023873 | biostudies-literature

Predictors of Left Ventricular Outflow Tract Obstruction After Primary Interrupted Aortic Arch Repair.

Project description:Left ventricular outflow tract obstruction is an important complication after interrupted aortic arch repair and subsequent interventions may adversely affect survival. Identification of patients at risk for obstruction is important to facilitate clinical decision-making and monitoring during follow-up. The aim of this review is to summarize reported risk factors for left ventricular outflow tract obstruction after corrective surgery for interrupted aortic arch. A systematic search of the literature was performed across the PubMed and EMBASE databases. Studies that reported echocardiographic and/or clinical predictors for left ventricular outflow tract obstruction in infants that underwent biventricular repair of interrupted aortic arch were included. From the 44 potentially relevant studies, eight studies met the inclusion criteria. Postoperative left ventricular outflow tract obstruction requiring an intervention was common, with an incidence ranging between 14 and 38%. Manifestation of postoperative left ventricular outflow tract obstruction was associated with a smaller pre-operative size of the aortic root (sinus of Valsalva), sinotubular junction, and aortic annulus. Anatomic and surgical risk factors for left ventricular outflow tract obstruction were the presence of an aberrant right subclavian artery, use of a pulmonary homograft or polytetrafluoroethylene interposition graft for aortic arch repair, and the presence of a small- or medium-sized ventricular septal defect. In patients with a borderline left ventricular outflow tract that undergo a primary repair, these (pre-) operative predictors can provide guidance for optimal surgical decision-making and for close monitoring during follow-up of patients at increased risk for developing left ventricular outflow tract obstruction after corrective surgery.

| S-EPMC8557160 | biostudies-literature

Left Ventricular Outflow Obstruction From Mechanical Circulatory Support in Critical Aortic Stenosis: A Cautionary Tale.

Project description:We submit a cautionary tale of a patient with critical aortic stenosis presenting with acute myocardial infarction and cardiogenic shock, who underwent balloon aortic valvuloplasty, insertion of a transvalvular left percutaneous ventricular assist device and high-risk percutaneous coronary intervention, with a post-operative course complicated by outflow obstruction from the device itself. (Level of Difficulty: Intermediate.).

| S-EPMC10157102 | biostudies-literature

Is it aortic stenosis or left ventricular outflow tract obstruction? The complementary role of four-dimensional flow cardiac magnetic resonance imaging.

Project description: Not available

| S-EPMC10493636 | biostudies-literature

An unusual cause of left ventricular outflow tract obstruction.

Project description:Left ventricular outflow tract obstruction (LVOTO) has been reported with bio-prosthetic and mechanical mitral valves (MV), though it is more common with the former. The obstruction can be dynamic or fixed. We hereby report a case of fixed LVOTO following bio-prosthetic MV replacement (MVR).

| S-EPMC4561759 | biostudies-literature

Unstable angina complicated with dynamic left ventricular outflow tract obstruction.

Project description:Left ventricular outflow tract obstruction (LVOTO) complicated with unstable angina (uAP) has not been described widely, but patients with these two conditions have several problems. Differentiation of the two conditions is also often difficult because the chest symptoms are similar. Moreover, nitrates are commonly used for ischemic heart disease, but have the effect of worsening LVOTO. We experienced three cases of dynamic LVOTO with a sigmoid-shaped septum, and without typical hypertrophic obstructive cardiomyopathy, that were complicated with uAP. In all cases, LVOTO was improved after initial percutaneous coronary intervention (PCI) for the left anterior descending artery lesion. Next, a dobutamine stress test was performed and LVOTO was provoked again in two cases, but not in a case with small acute myocardial infarction of the basal septum during PCI. All cases remained asymptomatic with beta-blocker therapy. Therefore, PCI and beta-blocker administration for LVOTO with uAP resulted in favorable clinical courses in all three cases. These outcomes suggest that revascularization including PCI should have priority in the therapeutic strategy for a case of acute coronary syndrome with LVOTO.

| S-EPMC8020068 | biostudies-literature

Dynamic Left Ventricular Outflow Tract Obstruction Exacerbated by Thoracic Kyphosis.

Project description:We present a 74-year-old woman with kyphosis and symptoms of pre/syncope. Heart catheterization revealed dynamic left ventricular outflow tract obstruction (DLVOTO) with Brockenbrough Braunwald response only when kyphotic posture was assumed. She had a positive response to metoprolol. DLVOTO is a challenging diagnosis in the absence of resting LVOTO. (Level of Difficulty: Beginner.).

| S-EPMC9911919 | biostudies-literature

Esmolol for acute pulmonary embolism with left ventricular outflow tract obstruction.

Project description: Not available

| S-EPMC8009630 | biostudies-literature