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Case Reports
. 2009 Sep 17:4:51.
doi: 10.1186/1749-8090-4-51.

Myocardial ischemia with left ventricular outflow obstruction

Aron F Popov  1 , Christian Bireta, Jan D Schmitto, Dieter Zenker, Martin Friedrich, Kasim O Coskun, Ralf Seipelt, Gerd G Hanekop, Friedrich A Schoendube
Affiliations
Case Reports

Myocardial ischemia with left ventricular outflow obstruction

Aron F Popov et al. J Cardiothorac Surg. .

Abstract

We report an unusual case of a 32-year old man who was treated for a hypertrophic obstructive cardiomyopathy (HOCM) with a DDD pacing with short AV delay reduction in the past. Without prior notice the patient developed ventricular fibrillation and an invasive cardiac diagnostic was performed, which revealed a myocardial bridging around of the left anterior descending artery (LAD). We suspected ischemia that could be either related to LAD artery compression or perfusion abnormalities due to AV delay reduction with related to diastolic dysfunction.

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Figures

Figure 1
Figure 1
Preoperative angiogram showing the appearance of the muscular bridge over the left anterior descending artery during systole.
Figure 2
Figure 2
Intraoperative view during the reconstruction of LAD.
Figure 3
Figure 3
Excised subaortic membrane.
Figure 4
Figure 4
Postoperative angiogram showing patent left anterior descending artery during systole, after incision muscular bridge and reconstruction.
See this image and copyright information in PMC

References

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