Post-mitral valve repair systolic anterior motion produced by non-obstructive septal bulge

A Successful Case of Percutaneous Transluminal Septal Myocardial Ablation for Mitral Regurgitation that Emerged Following Mitral Valve Repair Surgery

“…Civelek et al reported the incidence of recurrent MR due to LVOT obstruction to be 1.4% in patients with a septal bulge observed intraoperatively. The authors successfully prevented postoperative LVOT obstruction and MR by surgically resecting the septal bulge (16). However, in our case, we did not observe MR immediately after mitral valve repair, and the condition occurred late after surgery.…”

Systolic anterior motion after mitral valve repair: predicting factors and management

“…15 Although we cannot ascertain from their report whether the septal bulge is the same as the sigmoid septum, we believe that a sigmoid septum is one of the contributing factors for SAM after MV repair.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] The incidence ranges from 1% to 16% despite recent advances in MV repair techniques. [2][3][4][5][6][7][8][9][10][11][12][13][14][15] In patients with Barlow syndrome, the rate is as high as 26.7%. 10 A redundant posterior leafl et and an inadequate ring size are risk factors for SAM, but the precise mechanism is not fully understood.…”

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

“…Some have had better results from the AML reconstruction compared to PML reconstruction 16,22–24 . More recently, others have proposed that the proximal septal thickening may be the primary cause for the occurrence of SAM and have suggested septal myomectomy corrective surgery 25 . Finally, some surgeons have even recommended the Alfeiri stitch to prevent left ventricular outflow obstruction and SAM 26,27 .…”

“…This is an observational, retrospective study performed at the University Medical Center Vol. 25 A total of 385 patients underwent conventional mitral valve repair procedure, which consisted most commonly of posterior leaflet quadrangular resection and annuloplasty ring placement. These patients had intraoperative transesophageal echocardiograms (IOE) before and after the MVR procedure.…”