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We present a case of severe systolic anterior motion developing intraoperatively after aortic valve replacement for aortic valve stenosis.KEYWORDS aortic valve replacement; cardiopulmonary bypass; mitral valve; systolic anterior motion; transthoracic echocardiogram S ystolic anterior motion (SAM) of the mitral valve is a paradoxical motion of the anterior, and occasionally posterior, mitral valve leaflet toward the ventricular septum during ventricular systole. Although SAM is well reported in cases of hypertrophic cardiomyopathy, there are relatively fewer cases that describe severe SAM in association with aortic valve replacement (AVR) for aortic valve stenosis.

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