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Effective treatment of hypertrophic cardiomyopathy with left ventricular outflow tract obstruction using a covered stent

A woman in her 60s presented with progressive exertional dyspnoea, exertional chest pressure and exertional dizziness. Echocardiogram identified a 156 mm Hg left ventricular outflow tract gradient with provocation, indicating hypertrophic cardiomyopathy with left ventricular outflow obstruction—conf...

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Detalles Bibliográficos
Autores principales: Pekas, Devon, Chawda, Adya, Desai, Nayan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9764610/
https://www.ncbi.nlm.nih.gov/pubmed/36535735
http://dx.doi.org/10.1136/bcr-2022-250929
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author Pekas, Devon
Chawda, Adya
Desai, Nayan
author_facet Pekas, Devon
Chawda, Adya
Desai, Nayan
author_sort Pekas, Devon
collection PubMed
description A woman in her 60s presented with progressive exertional dyspnoea, exertional chest pressure and exertional dizziness. Echocardiogram identified a 156 mm Hg left ventricular outflow tract gradient with provocation, indicating hypertrophic cardiomyopathy with left ventricular outflow obstruction—confirmed with MRI and angiogram. An alcohol septal ablation was planned but due to communication of the second septal perforator with the right ventricle and a wire-induced mid-left anterior descending artery dissection, alcohol septal ablation was not performed. Instead, a covered stent was placed in the mid-left anterior descending artery covering the origins of the third and fourth septal perforators. The left ventricular outflow tract gradient decreased from 90 to 30 mm Hg with provocation and her symptoms improved. Follow-up showed a left ventricular outflow tract gradient of 35 mm Hg with provocation and decreased symptoms.
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spelling pubmed-97646102022-12-21 Effective treatment of hypertrophic cardiomyopathy with left ventricular outflow tract obstruction using a covered stent Pekas, Devon Chawda, Adya Desai, Nayan BMJ Case Rep Case Reports: Novel treatment (new drug/interventions; established drug/procedure in new situation) A woman in her 60s presented with progressive exertional dyspnoea, exertional chest pressure and exertional dizziness. Echocardiogram identified a 156 mm Hg left ventricular outflow tract gradient with provocation, indicating hypertrophic cardiomyopathy with left ventricular outflow obstruction—confirmed with MRI and angiogram. An alcohol septal ablation was planned but due to communication of the second septal perforator with the right ventricle and a wire-induced mid-left anterior descending artery dissection, alcohol septal ablation was not performed. Instead, a covered stent was placed in the mid-left anterior descending artery covering the origins of the third and fourth septal perforators. The left ventricular outflow tract gradient decreased from 90 to 30 mm Hg with provocation and her symptoms improved. Follow-up showed a left ventricular outflow tract gradient of 35 mm Hg with provocation and decreased symptoms. BMJ Publishing Group 2022-12-19 /pmc/articles/PMC9764610/ /pubmed/36535735 http://dx.doi.org/10.1136/bcr-2022-250929 Text en © BMJ Publishing Group Limited 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Case Reports: Novel treatment (new drug/interventions; established drug/procedure in new situation)
Pekas, Devon
Chawda, Adya
Desai, Nayan
Effective treatment of hypertrophic cardiomyopathy with left ventricular outflow tract obstruction using a covered stent
title Effective treatment of hypertrophic cardiomyopathy with left ventricular outflow tract obstruction using a covered stent
title_full Effective treatment of hypertrophic cardiomyopathy with left ventricular outflow tract obstruction using a covered stent
title_fullStr Effective treatment of hypertrophic cardiomyopathy with left ventricular outflow tract obstruction using a covered stent
title_full_unstemmed Effective treatment of hypertrophic cardiomyopathy with left ventricular outflow tract obstruction using a covered stent
title_short Effective treatment of hypertrophic cardiomyopathy with left ventricular outflow tract obstruction using a covered stent
title_sort effective treatment of hypertrophic cardiomyopathy with left ventricular outflow tract obstruction using a covered stent
topic Case Reports: Novel treatment (new drug/interventions; established drug/procedure in new situation)
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9764610/
https://www.ncbi.nlm.nih.gov/pubmed/36535735
http://dx.doi.org/10.1136/bcr-2022-250929
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