A Surgical Case of Midventricular Hypertrophic Obstructive Cardiomyopathy with Apical Aneurysm

Takuya Nishijima＊,＊＊	Kojiro Furukawa＊,＊＊	Yuichiro Hirata＊,＊＊
Tatsushi Onzuka＊,＊＊	Eiki Tayama＊,＊＊	Shigeki Morita＊,＊＊

（Department of Cardiovascular Surgery＊, and Clinical Research Institute＊＊, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan）

Hypertrophic cardiomyopathy with apical aneurysm is known to have high risk of a sudden death due to ventricular arrhythmias or thromboembolisms. We report a surgical case of surgical case of this disease. A 67-year-old man was found to have abnormality in an electrocardiogram during his checkup, and subsequent careful examinations revealed his disease. He had no symptoms and the pressure gradient at the obstruction was about 30mmHg, but there was thrombus in the apical aneurysm. After anticoagulant therapy, the thrombus dissolved. We scheduled an operation on him because he was judged to have high risk of a sudden death. In the operation, excision of the apical aneurysm, and hypertrophic midventricular myocardium were performed, concomitant with cryoablation to the border between the aneurysm and normal myocardium. Although complete atrioventricular block occurred postoperatively and he needed permanent pacemaker implantation, he was discharged from the hospital 21 days postoperatively without any other complications. He is doing well at two years and six months, postoperatively.

 

Jpn. J. Cardiovasc. Surg. 49:344-348（2020）

Keywords：hypertrophic cardiomyopathy;apical aneurysm