PMC9515485_01
PMC9515485_02
PMC9515485_03
Baseline clincal test pre surgery. (A) Left parasternal long axes showing severe left ventricular hypertrophy. (B) Doppler across the left ventricular outflow tract showing a peak gradient of 140 mmHg. (C) Baseline ECG before surgery. (D) Chest X Ray with SICD in place.
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F1
There was flow acceleration across the left ventricular outflow tract with a peak gradient over 140 mmHg and mean gradient of 60 mmHg at rest (see Figure 1).
Clincal test after surgery. (A) Left parasternal long axes showing significant reduction of interventricular septal thickness. (B) Doppler across the left ventricular outflow tract showing a peak gradient of 42 mmHg. (C) ECG after surgery showing the presence of a complete left bundle brunch block.
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F2
However, his ECG changed completely after surgery presenting a complete left bundle branch block as seen in Figure 2.
SICD vector analysis pre and after surgery. The primary vector failed due to high R-wave (out of range) and the secondary and alternate vectors failed due to low R:T ratio.
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F3
The primary vector failed due to high R-wave (out of range) and the secondary and alternate vectors failed due to low R:T ratio (Figure 3).