Abstract
A 47-year-old man with dilated-phase hypertrophic cardiomyopathy was admitted to the
hospital with worsening heart failure. As the enlarged atrium caused a constrictive
pericarditis-like hemodynamic condition, atrial wall resection and tricuspid valvuloplasty
were performed. Postoperatively, pulmonary artery pressure rose due to increased preload;
however, the rise in pulmonary artery wedge pressure was restrained, and the cardiac
output significantly improved. When the pericardium is extremely stretched due to
atrial enlargement, it can lead to an elevation of intrapericardial pressure, and
both atrial volume reduction and tricuspid valve plasty could lead to increased compliance
and contribute to hemodynamic improvement.
Learning objective
Atrial wall resection for massive atrial enlargement and tricuspid annuloplasty in
patients with diastolic-phase hypertrophic cardiomyopathy effectively relieves unstable
hemodynamics.
Keywords
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Article info
Publication history
Published online: February 09, 2023
Accepted:
January 4,
2023
Received in revised form:
December 15,
2022
Received:
August 4,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.