Experience with twenty-eight cases of systolic anterior motion after mitral valve reconstruction by the Carpentier technique

Transient Severe Mitral Regurgitation after Mitral Valve Repair Is Associated with a Poor Clinical Outcome: A Small Case Series

“…8 Since then SAM has been observed and studied extensively in patient undergoing mitral valve reconstruction both with and without the use of annuloplasty rings. [9][10][11][12][13][14][15][16][17] There have been numerous studies and hypotheses to explain the systolic anterior motion of the mitral valve causing left ventricular outflow obstruction and transient MR after a mitral valve repair procedure. Most experts believe that high blood flow velocities in the left ventricular outflow tract produce a Venturi effect that in part may lead to the anterior motion of the mitral valve leaflets toward the septum.…”

“…26,27 Although, there has been a definite reduction in the occurrence of SAM with surgical proficiency, the incidence remains between 2% and 9%. 9,13,23,28 Medical treatment with the withdrawal of positive inotropes and volume replacement has been the standard of care intraoperatively to prevent the need to repeat a surgical procedure to correct the SAM and MR. 17 The long-term implications of this medical therapy is unknown and none of these previous reports with post-MVR SAM commented on a different outcome based on the transient severity of the coexistent MR. It is likely that these patients subsequently have recurring episodes of catecholamine surges as well as intermittent hypovolemia.…”

Obstruction of the left ventricular outflow tract after mitral valvuloplasty with implantation of Gregori's ring

“…It is effective in the treatment of mitral insufficiency and double lesion, and should be performed whenever possible 1 . The most common complication reported is obstruction of the left ventricular outflow tract due to systolic anterior motion of the mitral valve [2][3][4][5][6][7] . Termini et al 2 were the first to report this complication in 1977.…”

“…Termini et al 2 were the first to report this complication in 1977. Its incidence has ranged from 2.7% to 10% 3,5,7 . The therapeutic management is controversial between valvar replacement 3,6 and clinical treatment 2,4,5 .…”

“…Its incidence has ranged from 2.7% to 10% 3,5,7 . The therapeutic management is controversial between valvar replacement 3,6 and clinical treatment 2,4,5 . We report a case of severe obstruction of the left ventricular outflow tract after mitral valvuloplasty with implantation of a Gregori's ring, in which the clinical treatment consisted of the suspension of the vasoactive drugs and introduction of a beta-blocker.…”