Abstract
Critical aortic valve stenosis is a common heart disease. The main cause of stenosis is calcinosis of the aortic valve. In some patients, a clinical picture may be comlicated by concomitant asymmetric hypertrophy of the interventricular septum, represented by its uneven thickening. Ample evidence about the absence of a regression of septal hypertrophy after isolated aortic valve replacement confirms the necessity of combined intervention with a valve replacement and myectomy of the hypertrophied part of the interventricular septum. This article presents a clinical case of a patient with critical aortic stenosis with a peak pressure gradient of 188 mm Hg and a valve opening area of 0.4 cm2 and an interventricular septum thickness of 25 mm. Preoperative examination of the patient using contemporary diagnostic methods including computed tomography of the heart with three-dimensional reconstruction allowed to perform a detailed analysis of the intracardiac anatomy. Septal myectomy and aortic valve replacement with Sorin № 23 mechanical prosthesis was performed. Postoperative period proceeded without any complications. Thus, a detailed preoperative examination of a patient helps to determine the optimal treatment strategy for the patient and the scope of surgery.
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About the authors
- Leo A. Bockeria, Academician of Russian Academy of Sciences and Russian Academy of Medical Sciences, President; ORCID
- Ol’ga L. Bockeria, Dr. Med. Sci., Professor, Corresponding Member of RAS; ORCID
- Zamik F. Fatulaev, Dr. Med. Sci., Researcher, Cardiovascular Surgeon; ORCID
- Vitaliy B. Andreev, Cardiologist
- Lasha D. Shengeliya, Dr. Med. Sci., Cardiovascular Surgeon,
