An unusual cause of left ventricular outflow tract obstruction

Abstract

Left ventricular outflow tract obstruction (LVOTO) has been reported with bio-prosthetic and mechanical mitral valves (MV), though it is more common with the former. The obstruction can be dynamic or fixed. We hereby report a case of fixed LVOTO following bio-prosthetic MV replacement (MVR).

Malaligned bioprosthetic valve causing left ventricular outflow tract obstruction

“…LVOT obstruction due to strut malposition is a rare complication of bioprosthetic mitral valve replacement surgery . Risk factors for this complication are prosthetic and/or patient‐related.…”

“…LVOT obstruction due to strut malposition is a rare complication of bioprosthetic mitral valve replacement surgery. [1][2][3][4][5][6][7] Risk factors for this complication are prosthetic and/or patient-related. Prostheticrelated factors include insertion of a high profile valve which may protrude into and obstruct the outflow tract.…”

“…10 To date, only a handful of cases of LVOT obstruction due to a malaligned bioprosthetic strut have been reported. [1][2][3][4][5][6][7] Symptomatic patients may require valve re-replacement. 1 In those too ill to undergo surgery, successful outcomes have been reported following alcohol septal ablation.…”

“…[1][2][3][4][5][6][7] Symptomatic patients may require valve re-replacement. 1 In those too ill to undergo surgery, successful outcomes have been reported following alcohol septal ablation. 2,3 Medical therapy consists of beta blockers and, if feasible, avoidance of diuretics.…”