case_images: PMC11189008_01
case_images: Computed tomography images. (a) Preoperative computed tomography images at the systolic (left upper) and diastolic phases (left lower). Diastolic transesophageal echography (right) showing widespread left ventricular (LV) hypertrophy from the anteroseptal wall to the apex. (b) Postoperative computed tomography images at the systolic (left upper) and diastolic phases (left lower) and transesophageal echography at the diastolic phase (right) show an improved LV cavity.
case_images: 10.1177_2050313X241263704-fig1.jpg
case_images: PMC11189008_01_10.1177_2050313X241263704-fig1.jpg
case_images: fig1-2050313X241263704
case_images: The LV diastolic dimension was 48 mm, the LV systolic dimension was 33 mm, the intraventricular septal thickness in diastole was 18 mm, the LV posterior wall thickness in diastole was 11 mm, and the LV ejection fraction was 59% (Figure 1(a)). The LV diastolic dimension was 48 mm, the LV systolic dimension was 33 mm, the intraventricular septal thickness in diastole was 12 mm, the LV posterior wall thickness in diastole was 9 mm, and the LV ejection fraction was 59% (Figure 1(b)).
case_images: Septal myectomy. (a) A transaortic view of the bulging hypertrophied septum below the right coronary valve leaflet (yellow arrow). (b) An apical incision is made in the avascular area, approximately 6 cm in length, 2 cm lateral to the left anterior descending artery (yellow arrow). (c) Combined transapical and transaortic myectomy was performed in the left ventricular cavity using the 11th scalpel blade.
case_images: 10.1177_2050313X241263704-fig2.jpg
case_images: PMC11189008_01_10.1177_2050313X241263704-fig2.jpg
case_images: fig2-2050313X241263704
case_images: Transverse aortotomy was performed, and the classical portion of myectomy involved making parallel longitudinal incisions in the septum using the 11th scalpel blade, as described by Morrow   (Figure 2(a)). A combined transapical and transaortic and myectomy was performed to address the widespread LV hypertrophy from the anteroseptal wall to the apex (Figure 2(b) and 2(c)).