Üzeyir YILMAZ, Mustafa KARAARSLAN, Sabit SARIKAYA
Türk Göğüs Kalp Damar Cerrahisi Dergisi - 2026;34(3):267-268
We express our gratitude to the authors for their interest in our case report and their insightful comments concerning intraventricular obstruction and the application of advanced imaging techniques in the context of left ventricular aneurysm subsequent to Takotsubo syndrome. In response to their initial inquiry, preoperative transthoracic echocardiography revealed no evidence of a left ventricular outflow tract or midventricular gradient at rest. The echocardiographic assessment did not indicate dynamic obstruction, systolic anterior motion, or a Doppler-derived intraventricular pressure gradient. Consequently, the preoperative findings did not support the hypothesis of a mechanically triggered Takotsubo syndrome due to resting intraventricular obstruction. Although cardiac magnetic resonance imaging was considered, it could not be conducted. The patient was in a hemodynamically precarious state with progressive clinical deterioration, necessitating urgent surgical intervention. Postponing surgery for additional imaging was deemed unsafe, and the decision for immediate operative management was based on clinical, echocardiographic, and intraoperative findings. We trust that these clarifications address the concerns raised and substantiate the individualized management strategy employed in this case. We appreciate the authors' constructive comments, which have enriched the discussion of this rare clinical entity.
