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[A case of surgically treated hypertrophic obstructive cardiomyopathy suffering from angina pectoris during
M Yamada1, A Ozawa, S Sekiguchi
1Department of Surgery, School of Medicine, Showa University, Tokyo, Japan.
Insights
This case report details a surgical procedure for hypertrophic obstructive cardiomyopathy (HOCM) in a patient undergoing chronic hemodialysis. The successful intervention relieved angina and reduced the left ventricular outflow tract pressure gradient.
Area of Science:
- Cardiology
- Cardiac Surgery
- Nephrology
Background:
- Hypertrophic obstructive cardiomyopathy (HOCM) poses unique challenges in patients requiring chronic hemodialysis.
- Surgical interventions for HOCM in this specific patient population have not been previously documented in Japan.
Observation:
- A 61-year-old male on chronic hemodialysis experienced angina pectoris during dialysis sessions.
- Cardiac catheterization revealed a significant systolic pressure gradient (79 mmHg) at the left ventricular outflow tract and severe mitral regurgitation.
Findings:
- The patient underwent successful mitral valve replacement and left ventricular myectomy.
- The surgery was performed concurrently with hemodialysis and extracorporeal ultrafiltration during cardiopulmonary bypass.
- Postoperative assessment showed a marked reduction in the pressure gradient to 19 mmHg and complete relief of angina.
Implications:
- This case demonstrates the feasibility and efficacy of surgical correction for HOCM in patients on chronic hemodialysis.
- The combined surgical and extracorporeal ultrafiltration technique offers a potential solution for managing complex cardiac conditions in renal failure patients.
- Further research is warranted to establish this approach as a standard treatment option.
Abstract:
Surgical procedure for hypertrophic obstructive cardiomyopathy (HOCM) in a patient chronic hemodialysis has not been reported in Japan. This is a case report of a 61-year-old male who had been suffering from angina pectoris during hemodialysis. Cardiac catheterization showed a systolic pressure gradient of 79 mmHg at the left ventricular outflow tract and left ventriculogram demonstrated severe mitral regurgitation. He underwent mitral valve replacement and left ventricular myectomy with hemodialysis and extracorporeal ultrafiltration method during cardiopulmonary bypass. Postoperative catheterization showed a decrease of pressure gradient to 19 mmHg at the left ventricular outflow tract, and relief of angina was obtained.