Magnetic resonance imaging abnormalities in the basal interventricular septum of patients with left ventricular outflow tract arrhythmias

2019 ◽  
Author(s):  
Christopher Reithmann ◽  
Theresia Kling ◽  
Bernhard Herkommer ◽  
Michael Fiek ◽  
Michael Ulbrich
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Left Ventricular Outflow Tract ◽  
Interventricular Septum ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Resonance Imaging ◽  
Left Ventricular Outflow ◽  
Outflow Tract Arrhythmias

Postoperative complications after the Mustard operation for complete transposition—a qualitative evaluation with magnetic resonance imaging

1996 ◽  
Vol 6 (1) ◽  
pp. 62-68 ◽  
Author(s):  
Harald Kaemmerer ◽  
Peter Theissen ◽  
Eckart Schirg ◽  
Renate Kaulitz ◽  
Harald Schicha ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Left Ventricular Outflow Tract ◽  
Spin Echo ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Resonance Imaging ◽  
Gradient Echo ◽  
Complete Transposition ◽  
Left Ventricular Outflow

AbstractLong-term follow-up studies after intraatrial repair for complete transposition have shown postoperative morphologic and hemodynamic abnormalities in many patients which often require reevaluation and therapeutic intervention. The purpose of this study was to assess, using magnetic resonance imaging, the presence and extent of late postoperative complications in a large cohort of 44 patients undergoing repair with the Mustard procedure. Of these 34 had an intact ventricular septum with or without obstruction of the left ventricular outflow tract, while 10 had an associated ventricular septal defect. Transverse spin-echo and gradient-echo images were acquired of the entire heart from the diaphragm to the bifurcation of the pulmonary trunk. Additional oblique images were acquired for better visualization of venous connections. Abnormal findings were diagnosed by visual inspection of spin-echo and gradient-echo images, and diagnoses were compared to previous findings at cardiac catheterization. On magnetic resonance imaging, a baffle leak was seen in eight patients, two had pulmonary venous obstruction, four had obstruction at the caval veins, 23 had obstruction of the left ventricular outflow tract and 18 had tricuspid regurgitation. Cardiac catheterization showed a leak across the baffle in 16, pulmonary venous obstruction in two, obstruction at the caval veins in four, obstruction of the left ventricular outflow tract in nine, and tricuspid regurgitation in nine. We conclude that combined spin-echo and gradient-echo magnetic resonance imaging provides extensive noninvasive assessment of postoperative sequels and residuals in patients after the Mustard procedure for complete transposition.

scholarly journals Membranous septal aneurysm in a child with Noonan syndrome and hypertrophic cardiomyopathy

2021 ◽  
Author(s):  
PRIYADARSHINI ARUNAKUMAR ◽  
Usha MK ◽  
RAMYA S ◽  
Jayaranganath M
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Mitral Valve ◽  
Noonan Syndrome ◽  
Left Ventricular Outflow Tract ◽  
Interventricular Septum ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Mitral Leaflet ◽  
Left Ventricular Outflow

A four year old boy was diagnosed with hypertrophic cardiomyopathy with moderate degree of obstruction of the left ventricular outflow tract, secondary to asymmetric septal hypertrophy and no features of congestive heart failure, at the age of the 7 months. He was also found to have myxomatous mitral valve, systolic anterior motion of anterior mitral leaflet and moderate mitral regurgitation. There was no evidence of ventricular septal defect at this point in time.In view of phenotypic features suggestive of Noonan syndrome, he underwent genetic evaluation with target gene sequencing and was detected to have a novel heterozygous mutation in exon 13 of LZTR 1 (Leucine- zipper-like transcriptional regulator 1) gene. Echocardiogram on follow up showed increase in left ventricular outflow tract obstruction and appearance of an aneurysm in the membranous portion of interventricular septum. There were no features of right ventricular outflow obstruction, tricuspid regurgitation or aortic regurgitation. The appearance of the membranous septal aneurysm may be related to the direction of jet arising from the point of contact of the anterior mitral leaflet with the hypertrophied basal septum and hitting this part of the interventricular septum. It is an unusual mechanism for formation of membranous septal aneurysm, given its absence in the earlier echocardiograms and absence of any left to right shunt across the aneurysm. He has been initiated on beta blockers due to severe left ventricular outflow tract obstruction and is planned for septal myomectomy, resection of membranous septal aneurysm and mitral valve repair.

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