case_images: PMC9515485_01
case_images: PMC9515485_02
case_images: PMC9515485_03
case_images: Baseline clincal test pre surgery. (A) Left parasternal long axes showing severe left ventricular hypertrophy. (B) Doppler across the left ventricular outflow tract showing a peak gradient of 140 mmHg. (C) Baseline ECG before surgery. (D) Chest X Ray with SICD in place.
case_images: fped-10-932390-g0001.jpg
case_images: PMC9515485_03_fped-10-932390-g0001.jpg
case_images: F1
case_images: There was flow acceleration across the left ventricular outflow tract with a peak gradient over 140 mmHg and mean gradient of 60 mmHg at rest (see Figure 1).
case_images: Clincal test after surgery. (A) Left parasternal long axes showing significant reduction of interventricular septal thickness. (B) Doppler across the left ventricular outflow tract showing a peak gradient of 42 mmHg. (C) ECG after surgery showing the presence of a complete left bundle brunch block.
case_images: fped-10-932390-g0002.jpg
case_images: PMC9515485_03_fped-10-932390-g0002.jpg
case_images: F2
case_images: However, his ECG changed completely after surgery presenting a complete left bundle branch block as seen in Figure 2.
case_images: SICD vector analysis pre and after surgery. The primary vector failed due to high R-wave (out of range) and the secondary and alternate vectors failed due to low R:T ratio.
case_images: fped-10-932390-g0003.jpg
case_images: PMC9515485_03_fped-10-932390-g0003.jpg
case_images: F3
case_images: The primary vector failed due to high R-wave (out of range) and the secondary and alternate vectors failed due to low R:T ratio (Figure 3).