[OBSTRUCTION OF THE OUTFLOW TRACT OF THE LEFT VENTRICLE DURING CARDIAC SURGERY]

Obstruction of the outflow tract of the left ventricle is well understood as a complication of hypertrophic cardiomyopathy. But other clinical situations are not described in Russian. The aim of this work was the description of the clinical, echocardiographic criteria and pathogenetically substantiated therapy dynamic subaortic obstruction in operations with extracorporeal circulation. Routine echocardiographic monitoring allowed to register obstruction of the outflow tract of the left ventricle in 10 patients during heart surgery (7 men, 3 women) aged 71 ± 16 years, when dealing with extracorporeal circulation (66 ± 22 min): 2 cases--correction of defects of the heart valves, 7--coronary artery bypass grafting. Early diagnosis of this complication in 8 cases, provided a rational choice of effective treatment strategy providing for the rejection of cardiotonics, the appointment of a beta-blocker, infusion therapy maintaining a relative of hypertension. Two patients died, despite the measures taken. Thus, obstruction of the outflow tract of the left ventricle is a rare but dangerous complication of cardiac surgery. Its timely diagnosis is possible using intraoperative echocar- diography.