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J Thorac Cardiovasc Surg 2006;132:173-174
© 2006 The American Association for Thoracic Surgery

Brief Communication

Percutaneous closure of a ventricular septal defect after surgical treatment of hypertrophic cardiomyopathy

D. De Wolf, MD, PhD a , * , Y. Taeymans, MD, PhD b , B. Suys, MD c , D. Matthys, MD, PhD a , G. Van Nooten, MD, PhD d

a Department of Congenital Cardiology, Ghent University Hospital, Ghent, Belgium
b Department of Cardiology, Ghent University Hospital, Ghent, Belgium
d Department of Cardiac Surgery, Ghent University Hospital, Ghent, Belgium
c Department of Congenital Cardiology, Antwerp University Hospital, Antwerp, Belgium

Received for publication December 23, 2005; revisions received January 4, 2006; accepted for publication January 10, 2006.

* Address for reprints: Daniël De Wolf, MD, PhD, Kindercardiologie UZ Gent, De Pintelaan 185, 9000 Gent, Belgium. (Email: Daniel.dewolf@ugent.be).

The first 20% of the full text of this article appears below.

Surgery or ethanol ablation is indicated in patients with hypertrophic cardiomyopathy who have symptomatic New York Heart Association (NYHA) class III disease with severe left ventricular outflow tract (LVOT) gradients despite medical treatment. 1 Go A ventricular septal defect (VSD) after surgical treatment is rare. 2 Go Alternatives for surgical closure are available in patients with congenital VSDs or post–myocardial infarction VSDs. Percutaneous closure provides a reasonable alternative. 3,4 Go

We describe the technique of percutaneous closure of a VSD after surgery for hypertrophic cardiomyopathy. 5 Go

Clinical Summary

A 50-year-old man was referred for surgery with symptomatic hypertrophic cardiomyopathy despite medical therapy. He was in NYHA class III with effort-related angina. Echocardiography showed asymmetrical left ventricular hypertrophy with a septal end-diastolic thickness of 19 mm, systolic anterior motion, an ejection fraction of 66%, and an LVOT gradient of 64 mm Hg. During catheterization the pressure gradient measured 100 mm Hg. Ethanol ablation failed. A surgical procedure was performed via a transaortic approach. By a Morrow septal myomectomy the LVOT was increased from 16 to 23 mm. However, on control . . . [Full Text of this Article]






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