Case report highlights surgical management of midcavitary obstruction in two pediatric patients with papillary muscle abnormalities, suggesting careful diagnosis is crucial.
Abnormalities of the left ventricular papillary muscles, albeit rare, can be clinically significant. We report two pediatric cases with thickened, fused papillary muscles obstructing left ventricle inflow with abnormal attachments to the ventricular septum leading to midcavitary outflow obstruction. Surgical management, consisting of septal myectomy, splitting of hypertrophied muscles, and resection of fibrous adhesions, successfully relieved obstruction. These cases underscore the importance of considering papillary muscle abnormalities in the differential diagnosis of midcavitary obstruction.
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El-Gayar et al. (2025) studied this question.
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