Life Threatening Reactive Left Ventricular Hypertrophy Due to Increased Blood Flow after Coronary Artery Bypass Grafting

A 68-year-old patient with triple vessel coronary artery disease was scheduled for elective coronary artery bypass grafting. Three days after the uneventful surgery, the patient went into cardiogenic shock, which was deemed to be caused by a dynamic left ventricular outflow tract obstruction and high-grade mitral regurgitation, which both had not been present before surgery. On an emergency basis, surgical transvalvular septal myectomy and mitral valve replacement were performed. After initial extra corporeal membrane oxygenation (ECMO) therapy and a prolonged (intensive care unit) ICU stay the patient finally recovered and is well one and a half years after surgery.