Fixed left ventricular outflow tract obstruction in presumed hypertrophic obstructive cardiomyopathy: implications for therapy Charles J Bruce, MB, Rick.

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Presentation transcript:

Fixed left ventricular outflow tract obstruction in presumed hypertrophic obstructive cardiomyopathy: implications for therapy Charles J Bruce, MB, Rick A Nishimura, MD, A.Jamil Tajik, MD, Hartzell V Schaff, MD, Gordon K Danielson, MD The Annals of Thoracic Surgery Volume 68, Issue 1, Pages 100-104 (July 1999) DOI: 10.1016/S0003-4975(99)00447-6

Fig 1 Patient 1. (A and B) Two-dimensional parasternal long-axis view in diastole (A) and systole (B) demonstrating the accessory mitral valve tissue (arrows) and associated discrete subaortic stenosis. (C) Continuous-wave Doppler of the left ventricular outflow tract (LVOT) and region of subaortic stenosis demonstrating the late-peaking dynamic velocity profile and early-peaking fixed velocity profile, respectively. Ao = aorta; LA = left atrium; LV = left ventricle; MV = mitral valve; PW = posterior wall of the left ventricle; RV = right ventricle; VS = interventricular septum. The Annals of Thoracic Surgery 1999 68, 100-104DOI: (10.1016/S0003-4975(99)00447-6)

Fig 2 Patient 2. Biplane transesophageal echocardiographic long-axis view through the left ventricular outflow tract demonstrating subaortic tunnel stenosis (Tunnel). AV = aortic valve; MV = mitral valve. The Annals of Thoracic Surgery 1999 68, 100-104DOI: (10.1016/S0003-4975(99)00447-6)

Fig 3 Patient 3. Biplane transesophageal echocardiographic long-axis view of the left ventricular outflow tract in systole demonstrating the subaortic tunnel (Tunnel). AV = aortic valve; LA = left atrium; MV = mitral valve. The Annals of Thoracic Surgery 1999 68, 100-104DOI: (10.1016/S0003-4975(99)00447-6)

Fig 4 Patient 4. Two-dimensional long-axis view of the left ventricular outflow tract (LVOT) demonstrating discrete subaortic stenosis (arrows). AV = aortic valve; MV = mitral valve; VS = ventricular septum. The Annals of Thoracic Surgery 1999 68, 100-104DOI: (10.1016/S0003-4975(99)00447-6)