The pathologic substrate of left ventricular outflow tract obstruction

Left ventricular outflow tract (LVOT) obstruction remains a major challenge in pediatric cardiology and surgery. One of the reasons being that the anatomy of the LVOT is complex, because of the participation of several components of different origin, such as the muscular outlet septum and the mitral valve apparatus. As a consequence, the pediatric cardiologist has to face the fact that imaging techniques may fail to demonstrate the subtle intricate anatomy of the LVOT, and the surgeon often will have to improvise once confronted with the anatomic details.