ArticleEuropean heart journal. Case reports2025
Left ventricular outflow tract obstruction caused by abnormal mitral valve tendinous Chordae manifesting in the extremely remote period after surgery for partial atrioventricular septal defect: a case report.
Article in European heart journal. Case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Forward Dynamics: Modern Insights into Mitral Systolic Anterior Motion.Journal of cardiovascular development and disease · 2026Review
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5 authors.
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Abstract
Background: Atrioventricular septal defect (AVSD) is a congenital heart disease characterized by intracardiac shunting due to septal defects, often associated with left ventricular outflow tract obstruction (LVOTO) caused by myocardial anomalies. Surgical intervention is recommended for AVSD if needed. This case report presents a rare case of LVOTO developing in the extremely remote period after partial Atrioventricular septal defect (pAVSD) surgery. Case Summary: A 35-year-old man with a history of intracardiac repair for pAVSD presented with worsening exertional dyspnoea. Transoesophageal echocardiography led to the diagnosis of LVOTO caused by systolic anterior motion (SAM) of an abnormal chordae without myocardial hypertrophy and mitral valve prolapse. Medical therapy was attempted but proved completely ineffective, so surgical resection of the abnormal chordae causing SAM was performed via open-heart surgery. Postoperatively, the LVOTO resolved, and the patient's symptoms disappeared. Discussion: AVSD has anatomical characteristics that allow it to be associated with LVOTO in various forms; however, much remains unknown about the modes of onset and the progression of the condition. It is reported that most cases of LVOTO after intracardiac repair of AVSD occur within five years postoperatively; however, rare cases can present in the late postoperative period. Among these are cases in which symptoms become apparent due to rare anatomical features such as chordal SAM, or haemodynamic changes associated with lifestyle modifications.
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