Hypertrophic obstructive cardiomyopathy associated with mitral regurgitation due to infective endocarditis

A 25-year-old woman treated for hypertrophic obstructive cardiomyopathy and suffering from mitral regurgitation due to infective endocarditis was referred to our department for surgery. Preoperative examinations revealed asymmetric septal hypertrophy, a large left ventricular outflow gradient (100 mmHg), and perforation of the anterior mitral leaflet resulting in severe mitral regurgitation. The entire mitral complex was resected and septal myectomy conducted to dilate the left ventricle. A bioprosthetic valve was then implanted. Although postoperative heart failure was severe, cardiac function has gradually recovered. The left ventricular outflow gradient has decreased to 8 mmHg, the diastolic left ventricular diameter has increased from 26 to 30 mm, and her New York Heart Association classification has improved from IV to I.