We note the important thickness of the septal wall at 26mm,
(arrow) the reduction of caliber of the LV and the hunting chamber
(star) with dilatation of left atrium (arrow head)
The patient was operated on day 3 of his admission with mitral valve
replacement + septal myomectomy
Then he was put on an intravenous antibiotic treatment (imipenem,
teicoplanin and gentamicin)
The evolution was marked by an improvement with apyrexia, regression of
the biological inflammatory syndrome and disappearance of the sub-aortic
gradient and mitral insufficiency.
During the follow-up :
7 days after the operation, the patient presented a convulsive seizures.
A cerebral CT scan was performed, it showed a cerebral hematoma with
quadri ventricular flooding, sub arachnoid hemorrhage and a diffuse
cerebral edema responsible for cerebral herniation; sub falcoriel,
central, temporal (figure 6).