scholarly journals Progressive Left Ventricular Hypertrophy After Ozaki Procedure: A Case Report

2020 ◽  
Vol 23 (6) ◽  
pp. E740-E742
Author(s):  
Trang Nguyen ◽  
Anh Vo ◽  
Danh Nguyen ◽  
Thanh Vu ◽  
Dinh Nguyen
Keyword(s):  
Case Report ◽  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Left Ventricular Outflow Tract ◽  
Severe Aortic Stenosis ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Septal Myectomy ◽  
Valve Reconstruction ◽  
Left Ventricular Outflow

We describe a 57-year-old man with symptomatic severe aortic stenosis who underwent aortic valve reconstruction with glutaraldehyde-treated autologous pericardium with the Ozaki technique (Ozaki procedure). Seven months later, he rapidly developed progressive left ventricular hypertrophy with a left ventricular outflow tract obstruction. This required a reoperation for septal myectomy.

scholarly journals Focused cardiac echocardiography in beach-chair position surgery: A case study

2019 ◽  
Vol 47 (4) ◽  
pp. 385-388
Author(s):  
Paul F Soeding ◽  
Amelia Steel ◽  
James Wong ◽  
Gregory A Hoy
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Cardiac Ultrasound ◽  
Focused Cardiac Ultrasound ◽  
Beach Chair Position ◽  
Left Ventricular Outflow ◽  
Beach Chair

The haemodynamic response to the beach-chair position may be affected by the presence of left ventricular hypertrophy where remodelling of cardiac chambers can potentially lead to left ventricular outflow tract obstruction. We present a case report of severe hypotension in the beach-chair position, where focused cardiac ultrasound identified left ventricular hypertrophy and geometric features that contributed to the hypotensive response. This case illustrates that focused cardiac ultrasound has the potential to alert the clinician preoperatively to left ventricular outflow tract obstruction susceptibility during surgery in the beach-chair position, and intraoperatively to direct management should sudden decreases in blood pressure occur.

scholarly journals Treatment of severe aortic stenosis and left ventricular outflow tract mass with transcutaneous aortic valve implantation: a case report

2019 ◽  
Author(s):  
Hesham A Naeim ◽  
Waleed Saeed ◽  
Ibraheem Alharbi ◽  
Reda Abuelatta
Keyword(s):  
Case Report ◽  
Aortic Valve ◽  
Left Ventricular Outflow Tract ◽  
Severe Aortic Stenosis ◽  
Transoesophageal Echocardiography ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Left Ventricular Outflow ◽  
Aortic Valve Implantation ◽  
Valve Implantation

AbstractBackgroundPercutaneous implantation of aortic valve for severe aortic stenosis (AS) in the presence of pedunculated mobile left ventricular outflow tract (LVOT) mass not reported before. In this case report, we address the feasibility of this procedure.Case summaryAn 80-year-old patient who presented with presyncope, transthoracic echocardiogram (TTE), and transoesophageal echocardiography (TOE) revealed severe calcific AS and LVOT mass measuring 2.1*1.5 cm. The patient was turned down for surgery. It was decided that transcatheter aortic valve implantation (TAVI) be performed because the valve compresses the mass against the proximal part of the interventricular septum. The mass peduncle was 1.4 cm, and it was 4 mm away from the annulus. This meant the valve was needed to be deployed 18 mm below the annulus to cover the mass completely. Gentle manipulation and direct valve deployment without preballoon dilation to decrease the possibility of fragment embolization were necessary. Self-expandable core valve deployed as low as possible, after initial deployment, the distance of LVOT covered by the valve measured by TOE 1.66 cm, the whole mass was covered, then the valve was fully deployed. The patient was extubated in the catheterization room; there was no clinical evidence of embolization. The patient was discharged home after 2 days. A follow-up TTE after 6 months showed a well-functioning valve and the LVOT mass then disappeared.DiscussionPedunculated LVOT mass should be resected surgically. In high-risk surgical patients, direct TAVI to compress the mass is feasible in experienced canters. The safety issues need more research and more cases to judge. Transoesophageal echocardiography during the procedure is mandatory to guide the valve position.

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