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An Unusual Presentation of Persistent Dyspnea Following Alcohol Septal Ablation For Obstructive Hypertrophic Cardiomyopathy
  • Khaled Ghoniem,
  • Rick Nishimura,
  • Hartzell Schaff
Khaled Ghoniem
Mayo Clinic
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Rick Nishimura
Mayo Clinic
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Hartzell Schaff
Mayo Clinic
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Abstract

Residual or recurrent symptoms after septal reduction therapy are most often related to inadequate relief of left ventricular outflow gradients. We recently encountered a 71-year-old woman with hypertrophic cardiomyopathy (HCM) and prior alcohol septal ablation who had a unique constellation of findings causing her symptoms. She was found to have four potential causes for her symptoms, residual midventricular obstruction, apical distribution of hypertrophy reducing end-diastolic volume, constrictive pericarditis, and marked arterial stiffness, as reflected by aortic atherosclerosis. She underwent complete pericardiectomy, transaortic septal myectomy, transapical myectomy, and replacement of a heavily calcified ascending aorta.

Peer review status:ACCEPTED

02 Oct 2020Submitted to Journal of Cardiac Surgery
07 Oct 2020Submission Checks Completed
07 Oct 2020Assigned to Editor
13 Oct 2020Review(s) Completed, Editorial Evaluation Pending
13 Oct 2020Editorial Decision: Revise Major
06 Nov 20201st Revision Received
10 Nov 2020Submission Checks Completed
10 Nov 2020Assigned to Editor
23 Nov 2020Reviewer(s) Assigned
08 Dec 2020Review(s) Completed, Editorial Evaluation Pending
08 Dec 2020Editorial Decision: Accept