{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:25:06Z","timestamp":1760955906694,"version":"3.41.2"},"reference-count":4,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2019,1,31]],"date-time":"2019-01-31T00:00:00Z","timestamp":1548892800000},"content-version":"vor","delay-in-days":30,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Left ventricular outflow tract (LVOT) obstruction (LVOTO) is a rare but recognized complication of mitral valve surgery. Concomitant factors can cause significant clinical deterioration which requires urgent intervention. We present the case of a female patient who underwent closed valvotomy at age 20 for mitral stenosis secondary to rheumatic heart disease. Seventeen years later, a re-stenosed valve prompted mitral valve replacement (MVR) with a Carbomedics mechanical prosthesis. 8 years later, she re-presented with increasing dyspnoea. On echocardiogram a frond-like structure was visible in the LVOT, the valve housing was protruding into the LVOT and she had marked septal hypertrophy. The LVOT gradient was 72 mmHg. This is a novel case of mechanical MVR associated LVOTO due to at least three discrete factors. This case demonstrates how multiple factors can amalgamate to result in significant clinical deterioration. Over an 8-year period, all three distinct factors contributed to the development of severe LVOTO.<\/jats:p>","DOI":"10.1093\/jscr\/rjy357","type":"journal-article","created":{"date-parts":[[2018,12,24]],"date-time":"2018-12-24T12:08:08Z","timestamp":1545653288000},"source":"Crossref","is-referenced-by-count":3,"title":["A novel case of late left ventricular outflow tract obstruction post mitral valve surgery"],"prefix":"10.1093","volume":"2019","author":[{"given":"Andrew","family":"Jones","sequence":"first","affiliation":[{"name":"Cardiothoracic Surgery, University Hospital Southampton, Southampton, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Livesey","sequence":"additional","affiliation":[{"name":"Cardiothoracic Surgery, University Hospital Southampton, Southampton, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,1,11]]},"reference":[{"key":"2019073110001996500_rjy357C1","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1007\/s12574-017-0352-6","article-title":"Causes of an increased pressure gradient through the left ventricular outflow tract: a West Coast experience","volume":"16","author":"Kobayashi","year":"2017","journal-title":"J Echocardiogr"},{"key":"2019073110001996500_rjy357C2","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/S0003-4975(99)00496-8","article-title":"Left ventricular outflow tract obstruction with mitral mechanical prosthesis","volume":"68","author":"Melero","year":"1999","journal-title":"Ann Thorac Surg"},{"key":"2019073110001996500_rjy357C3","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1111\/jocs.12749","article-title":"Acute LVOT obstruction with a carbomedics mechanical valve prosthesis: LVOT obstruction by a cardbomedics valve","volume":"31","author":"Alsidawi","year":"2016","journal-title":"J Card Surg"},{"key":"2019073110001996500_rjy357C4","doi-asserted-by":"crossref","first-page":"S105","DOI":"10.1016\/j.ihj.2016.01.001","article-title":"Acquired discrete subaortic stenosis late after mitral valve replacement","volume":"68","author":"Mohan","year":"2016","journal-title":"Indian Heart J"}],"container-title":["Journal of Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jscr\/article-pdf\/2019\/1\/rjy357\/29023721\/rjy357.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,7,31]],"date-time":"2019-07-31T14:00:25Z","timestamp":1564581625000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jscr\/article\/doi\/10.1093\/jscr\/rjy357\/5304856"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1,1]]},"references-count":4,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,1,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jscr\/rjy357","relation":{},"ISSN":["2042-8812"],"issn-type":[{"type":"electronic","value":"2042-8812"}],"subject":[],"published-other":{"date-parts":[[2019,1]]},"published":{"date-parts":[[2019,1,1]]},"article-number":"rjy357"}}