Systolic anterior motion (SAM) of the posterior mitral leaflet: Left ventricular outflow tract obstruction in a patient without left ventricular hypertrophy

2006 ◽  
Vol 109 (2) ◽  
pp. 271-272 ◽  
Author(s):  
Tetsuya Doi ◽  
Hiroyuki Ayukawa ◽  
Yoshiaki Hoshiyama ◽  
Yuko Hatakeyama ◽  
Yoshio Sasaki ◽  
...  
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Systolic Anterior Motion ◽  
Mitral Leaflet ◽  
Posterior Mitral Leaflet ◽  
Left Ventricular Outflow

scholarly journals Trapezoidal resection of an elongated anterior mitral leaflet and Alfieri stitch in hypertrophic cardiomyopathy

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Hiroyuki Nakajima ◽  
Chiho Tokunaga ◽  
Jun Hayashi ◽  
Akitoshi Takazawa ◽  
Akihiro Yoshitake ◽  
...  
Keyword(s):  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Papillary Muscles ◽  
Systolic Anterior Motion ◽  
Mitral Leaflet ◽  
Septal Myectomy ◽  
Left Ventricular Outflow ◽  
Septal Hypertrophy

Abstract Background In individuals with hypertrophic obstructive cardiomyopathy, elongated anterior mitral leaflets are commonly associated with systolic anterior motion. In patients with mild septal hypertrophy, a myectomy is considered insufficient to relieve systolic anterior motion and left ventricular outflow tract obstruction. Case presentation In the patient, who had relatively mild septal hypertrophy, the section of the anterior leaflet protruding into the left ventricular outflow tract was resected, concomitant with septal myectomy and the relocation of the papillary muscles. An edge-to-edge stitch was placed at the uppermost segment of the coaptation zone. Using these manoeuvres, systolic anterior motion, left ventricular outflow tract obstruction and mitral regurgitation were successfully resolved postoperatively. Conclusions We describe a surgical technique with an edge-to-edge suture for the resection of an elongated anterior mitral leaflet. In combination with septal myectomy and relocation of the papillary muscles, this technique is a simple and viable option, especially when septal hypertrophy is not severe.

scholarly journals Dynamic left ventricular outflow tract obstruction in Takotsubo cardiomyopathy resulting in cardiogenic shock

2021 ◽  
Vol 14 (3) ◽  
pp. e240010
Author(s):  
Paulina M Conradi ◽  
Ramon B van Loon ◽  
M Louis Handoko
Keyword(s):  
Mitral Valve ◽  
Cardiogenic Shock ◽  
Left Ventricular Outflow Tract ◽  
Apical Ballooning ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Systolic Anterior Motion ◽  
Ventricular Outflow Tract Obstruction ◽  
Left Ventricular Outflow

We report a case of a 73-year-old female patient, who was admitted to the coronary care unit due to chest pain, malaise and near syncope. During physical examination, the patient was hypotensive and there were signs of left-sided heart failure and a loud systolic murmur. Echocardiogram showed apical ballooning with dynamic left ventricular outflow tract obstruction, based on systolic anterior motion of the mitral valve with important mitral valve regurgitation. In the acute setting, the cardiogenic shock was treated cautiously with fluid resuscitation and intravenous metoprolol, resulting in direct stabilisation of her haemodynamic condition. As a codiagnosis, there was a significant stenosis of left anterior descending artery, which was treated successfully by percutaneous coronary intervention with drug eluting stents. During follow-up, left ventricular function normalised, and the left ventricular outflow tract obstruction, systolic anterior motion of mitral valve and related mitral regurgitation all resolved.

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