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Critical Acute Left Ventricular Outflow Tract Obstruction Due to Cardiac Sarcoma.
JACC Case Rep
January 2025
Department of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota, USA.
Left ventricular outflow tract (LVOT) obstruction is mostly caused by hypertrophic obstructive cardiomyopathy and subaortic stenosis. Rarely, malignancy can lead to dynamic LVOT obstruction and has only been sporadically documented. We present the first case of dynamic and/or nearly fixed LVOT obstruction caused by a cardiac myxoid spindle cell sarcoma.
View Article and Find Full Text PDFTEER for SAM of the Mitral Valve and Flail Posterior Mitral Leaflet: 1-Clip Solution.
JACC Case Rep
January 2025
Department of Cardiovascular Medicine, Richmond Heart & Vascular Associates, Richmond, Virginia, USA.
Transcatheter edge-to-edge repair (TEER) is approved for patients with symptomatic severe mitral regurgitation (MR) who are deemed inoperable or at high surgical risk with life expectancy of more than 1 year, but has also been used off-label in patients with hypertrophic obstructive cardiomyopathy (HOCM) for symptomatic relief who are not candidates for septal reduction therapy. An 83-year-old woman with decompensated heart failure was found to have HOCM with systolic anterior motion of the mitral valve and a large P2 flail segment with ruptured cords. TEER was performed resulting in mild MR and resolution of the prior left ventricular outflow tract gradient.
View Article and Find Full Text PDFA Triple Threat: A Case Report Detailing Surgical Management for Hypertrophic Cardiomyopathy, Flail Mitral Valve and Severe Pulmonary Hypertension.
Reports (MDPI)
December 2024
Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA 98195, USA.
Unlabelled: The combination of hypertrophic cardiomyopathy with outflow tract obstruction, severe pre-capillary and post-capillary pulmonary hypertension, and severe primary mitral regurgitation is rare and presents distinct management challenges.
Background And Clinical Significance: Pulmonary hypertension is an independent predictor of all-cause mortality in patients with hypertrophic cardiomyopathy managed medically and often precludes patients from undergoing cardiopulmonary bypass due to increased surgical morbidity and mortality. In studies specifically evaluating surgical myectomy, however, survival is favorable in patients with moderate-to-severe pulmonary hypertension.
Background: Disopyramide is used to treat heart failure symptoms in patients with obstructive hypertrophic cardiomyopathy (HCM) with known medium-term efficacy and safety, while long-term outcomes are unknown.
Methods And Results: A total of 92 consecutive patients with symptomatic obstructive HCM with peak left ventricular outflow tract gradients of ≥30 mm Hg at rest or with provocation who were maintained on disopyramide for ≥5 years at 2 dedicated HCM centers were included: 92 patients; mean age, 62.5 years; 54% women; treated with disopyramide for median 7.
Long-Term Impact of Pregnancy on Clinical Outcomes in Individuals With Hypertrophic Cardiomyopathy.
JACC Adv
January 2025
Hypertrophic Cardiomyopathy Center, Division of Cardiovascular Medicine, University of Texas Medical Branch, Galveston, Texas, USA.
Background: The effect of pregnancy on individuals with hypertrophic cardiomyopathy (HCM) is not well investigated.
Objectives: The purpose of this study was to assess the impact of pregnancy on all-cause mortality and clinical outcomes among individuals with HCM.
Methods: Using the TriNetX research network, we identified individuals within reproductive age (≥18-45 years) with a diagnosis of HCM between 2012 and 2022 (n = 10,936).
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