PMC6571147_01
Transesophageal echocardiography B-mode views showing (
A
) preoperative septal hypertrophy (black asterisk) and a thick chord (white arrows) attached to the anterior mitral leaflet and the anterolateral papillary muscle, and (
C
) the postoperative result without left ventricular outflow tract (LVOT) obstruction. Measured septal wall thickness in (
C
) = 12 mm. (
B
) Image of the resected muscular chord (black arrow) and the resected segment of the hypertrophic septum (white arrow). Top scale on the bar measures centimeters.
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PMC6571147_01_10-1055-s-0039-1692155-i190329crc-1.jpg
FI190329crc-1
Thorough transesophageal echocardiography (TEE) control revealed an unaltered pathological LVOT gradient, SAM with mild mitral regurgitation and de novo detection of a subvalvular structure attached to the anterior mitral leaflet (AML) that seemed to contribute to LVOT obstruction ( Fig. 1A ). Fig. 1B ). Furthermore, a septal myectomy was performed resecting a segment of 1.0 cm depth, 1.5 cm width, and 2 cm length. TEE showed a wide LVOT and the absence of SAM ( Fig. 1C ). The LVOT gradient amounted to 10 mm Hg.