Key result
Intraoperative TEE guides unplanned septal myectomy, reducing severe LVOT gradient by ~85%.
Why the study?
Infective endocarditis rarely complicates hypertrophic cardiomyopathy, and anterior mitral valve leaflet involvement can cause severe LVOTO requiring immediate intervention and increasing mortality.
Case Report (n=1)
No
Absolute Event Rate: 10% vs 65%
Intraoperative transesophageal echocardiography can be useful in guiding mitral valve replacement in patients with hypertrophic obstructive cardiomyopathy and infective endocarditis.
May support intraoperative TEE in complex HOCM cases with endocarditis; leaves open need for prospective validation before broader adoption.
Hypertrophic cardiomyopathy is most commonly an autosomal genetic disorder characterized by increased morbidity. Infective endocarditis, although rare, can complicate the course of the disease. The mitral and aortic valves are more commonly affected. Mitral valve vegetations may cause severe regurgitation and acute heart failure. In the event that the anterior valve leaflet is affected, this may result in severe left ventricular outflow tract obstruction (LVOTO), requiring immediate intervention and resulting in a significant increase in mortality. We report a rare clinical case of a patient with hypertrophic cardiomyopathy complicated by mitral valve infective endocarditis and LVOTO.
No takes yet. Share an insight, caveat, or question.
Sarridou et al. (2025) conducted a case report in Hypertrophic cardiomyopathy complicated by mitral valve infective endocarditis and left ventricular outflow tract obstruction (n=1). Intraoperative transesophageal echocardiography (TOE) guided septal myectomy and mitral valve replacement vs. Baseline (pre-myectomy) was evaluated on Left ventricular outflow tract (LVOT) pressure gradient. Intraoperative transesophageal echocardiography revealed severe left ventricular outflow tract obstruction, guiding an unplanned septal myectomy that reduced the pressure gradient from 65 to 10 mmHg.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: