Related Experiment Video

Updated: Jun 10, 2026

Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
07:11

Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography

Published on: October 28, 2020

Hypertrophic obstructive cardiomyopathy causing severe right and left ventricular outflow tract obstruction

Gülümser Heper1, Muzaffer Celiksöz, Sevket Atasoy

  • 1Department of Cardiology, Medicine Faculty of Abant Izzet Baysal University, Bolu, Turkey. heperg@hotmail.com

Turk Kardiyoloji Dernegi Arsivi : Turk Kardiyoloji Derneginin Yayin Organidir
|August 3, 2010
PubMed

Insights

This study details a novel surgical approach for hypertrophic obstructive cardiomyopathy, successfully treating predominant right ventricular outflow tract obstruction with myectomy and graft patch interpositioning, leading to asymptomatic recovery.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery

Background:

  • Hypertrophic obstructive cardiomyopathy (HOCM) can present with significant outflow tract obstruction.
  • Right ventricular outflow tract (RVOT) obstruction is less common but can cause severe symptoms.

Observation:

  • An 18-year-old male with exertional dyspnea, dizziness, and angina showed severe biventricular hypertrophy and prominent RVOT muscular bundles.
  • High-pressure gradients were measured across the RVOT (141 mmHg) and left ventricular outflow tract (LVOT) (66 mmHg), with grade 2 aortic regurgitation.

Findings:

  • Medical management with propranolol and cibenzoline failed to alleviate symptoms or reduce pressure gradients.
  • Surgical intervention involving extensive RVOT myectomy, minimal LVOT resection, and RVOT graft patch interpositioning eliminated RVOT obstruction and reduced LVOT gradient to 28 mmHg.

Implications:

  • This case highlights a successful surgical strategy for HOCM with predominant RVOT obstruction.
  • The myectomy and patch graft technique offers a viable treatment option for complex outflow tract obstruction in hypertrophic cardiomyopathy.

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