Abnormal mitral valve apparatus in a case of hypertrophic obstructive cardiomyopathy: Intraoperative transesophageal echocardiography

Abstract

Hypertrophic obstructive cardiomyopathy is a relatively common disorder that signifies asymmetric hypertrophy of interventricular septum causing obstruction of the left ventricular outflow tract (LVOT). However, more recent studies have shown that during ventricular systole, flow against an abnormal mitral valve apparatus results in drag forces on the part of the leaflets. The mitral leaflet is pushed into the LVOT to obstruct it. We present a case where intraoperative transesophageal echocardiography played a crucial role in defining the etiology of LVOT obstruction that subsequently helped in deciding the surgical plan.

Abnormal mitral valve apparatus is not an indication for mitral valve replacement in hypertrophic obstructive cardiomyopathy

“…We read with interest the article by Aggarwal et al . [ 1 ] about the intraoperative echocardiography detection of abnormal mitral valve apparatus in a patient scheduled for surgery for hypertrophic obstructive cardiomyopathy in the latest issue of Annals . The authors need to be congratulated for detecting the various abnormalities of the mitral valve apparatus by intraoperative transesophageal echocardiography; however, we feel that the concomitant mitral valve replacement along with septal myectomy was probably unwarranted.…”