Concomitant surgical myectomy and aortic valve replacement is a feasible and effective treatment for patients with both hypertrophic obstructive cardiomyopathy and significant aortic stenosis.
Coexistence of HOCM and aortic stenosis may exacerbate symptoms in elderly patients; leaves open optimal management strategies pending further evidence.
A 72-year-old female was found to have symptomatic hypertrophic obstructive cardiomyopathy associated with significant aortic stenosis. She was found to have severe left ventricular outflow tract obstruction, asymmetric septal hypertrophy, significant systolic anterior motion of the anterior mitral valve leaflet, and mitral regurgitation. She was also found to have moderate aortic stenosis that made the obstruction even worse which made the patient progressively symptomatic not responding to medical therapy. She eventually underwent cardiac surgery in form of left ventricular septal myomectomy and bioprosthetic aortic valve replacement (tissue AVR) with a size 23 tissue valve, aortic root enlargement with bovine pericardial patch. She is currently stable on optimal medical therapy, feels much better and stable cardiac-wise with much better quality of life.
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Abdulgani Abonowara (2023) studied this question.
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