Midventricular Obstruction Caused by Abnormal Intra–Left Ventricular Septum and Papillary Muscles Takaaki Samura, MD, Koichi Toda, MD, PhD, Shunsuke.

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Presentation transcript:

Midventricular Obstruction Caused by Abnormal Intra–Left Ventricular Septum and Papillary Muscles Takaaki Samura, MD, Koichi Toda, MD, PhD, Shunsuke Saito, MD, PhD, Shigeru Miyagawa, MD, PhD, Yasushi Yoshikawa, MD, PhD, Satsuki Fukushima, MD, PhD, Daisuke Yoshioka, MD, Keitaro Domae, MD, Yoshiki Sawa, MD, PhD The Annals of Thoracic Surgery Volume 104, Issue 3, Pages e247-e249 (September 2017) DOI: 10.1016/j.athoracsur.2017.04.002 Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (Left) Transesophageal echocardiography revealed midventricular obstruction. (Right) Three-dimensional transesophageal echocardiography revealed an intra–left ventricular septum located in the midportion of the left ventricle, with a small hole (white arrows) at its center (yellow arrows: mitral valve). The Annals of Thoracic Surgery 2017 104, e247-e249DOI: (10.1016/j.athoracsur.2017.04.002) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (Left and right) Intraoperative photography revealed that the intra–left ventricular septum had a small hole (white arrows) at the center, through which a 21-mm surgical probe could not pass (yellow arrows: mitral annulus). The Annals of Thoracic Surgery 2017 104, e247-e249DOI: (10.1016/j.athoracsur.2017.04.002) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 (Left) Radical resection of the papillary muscles and the intra–left ventricular septum (white arrows) relieved the obstruction. (Right) A 26-mm surgical probe passed through the midportion of the left ventricle (yellow arrows: mitral annulus). The Annals of Thoracic Surgery 2017 104, e247-e249DOI: (10.1016/j.athoracsur.2017.04.002) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions