case_images: PMC11830273_01
case_images: Measurement of the LVOT Gradient. (A) Preablation resting gradient of approximately 50-60 mm Hg. (B) Preablation post-PVC gradient of approximately 110-120 mm Hg. (C) Postablation gradient of ~20-25 mm Hg.
case_images: gr1.jpg
case_images: PMC11830273_01_gr1.jpg
case_images: fig1
case_images: Severe left ventricular outflow tract (LVOT) obstruction was confirmed with a resting LVOT gradient of approximately 60 mm Hg and post-PVC gradient of up to 120 mm Hg (Figures 1A and 1B). His resting LVOT gradient had improved to 20 to 25 mm Hg (Figure 1C).
case_images: Identification of the Septal Perforator. (A) Angiography shows a large-caliber, branching first septal perforator (arrow). (B) An interventional wire and over-the-wire balloon were advanced into the smaller branch of the first septal perforator.
case_images: gr2.jpg
case_images: PMC11830273_01_gr2.jpg
case_images: fig2
case_images: Selective coronary angiography showed a patent left anterior descending artery (LAD) with a first septal perforator which was a large-caliber, branching vessel (Figure 2A). A 1.5 x 6.0 mm Sprinter over-the-wire (OTW) balloon was subsequently advanced over a 0.014-inch run-through wire into the smaller branch of the first septal perforator (Figure 2B).