Anesthetic Management of a Patient With Dynamic Left Ventricular Outflow Tract Obstruction With Systolic Anterior Movement of the Mitral Valve Undergoing Redo–Orthotopic Liver Transplantation

2012 ◽  
Vol 26 (2) ◽  
pp. 274-276 ◽  
Author(s):  
Debashis Roy ◽  
Fiona E. Ralley
Keyword(s):  
Liver Transplantation ◽  
Mitral Valve ◽  
Orthotopic Liver Transplantation ◽  
Left Ventricular Outflow Tract ◽  
Anesthetic Management ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Left Ventricular Outflow ◽  
Systolic Anterior Movement

scholarly journals Norepinephrine-associated left ventricular outflow tract obstruction and systolic anterior movement

2019 ◽  
Vol 12 (12) ◽  
pp. e225879 ◽  
Author(s):  
Warner Mbuila Mampuya ◽  
Jonathan Dumont ◽  
Francois Lamontagne
Keyword(s):  
Blood Pressure ◽  
Left Ventricular Outflow Tract ◽  
Myocardial Hypertrophy ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Increase Blood Pressure ◽  
Ventricular Outflow Tract Obstruction ◽  
Left Ventricular Outflow ◽  
Systolic Anterior Movement

In the perioperative setting, norepinephrine is used to increase blood pressure, an effect mediated mostly via arterial and venous vasoconstriction. Thus, norepinephrine is, allegedly, less likely to cause or worsen left ventricular outflow tract obstruction (LVOTO) than other inotropes. We report a case of norepinephrine-associated dynamic LVOTO and systolic anterior movement in a predisposed patient. This report highlights that unrecognised dynamic LVOTO may worsen shock parameters in patients treated with norepinephrine who have underlying myocardial hypertrophy.

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.

Critical Left Ventricular Outflow Tract Obstruction Due to Accessory Mitral Valve Tissue

2000 ◽  
Vol 17 (2) ◽  
pp. 177-180 ◽  
Author(s):  
RAFFAELE CALABRO ◽  
GIUSEPPE SANTORO ◽  
CARLO PISACANE ◽  
BERARDO SARUBBI ◽  
GABRIELLA FARINA ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Ventricular Outflow Tract Obstruction ◽  
Valve Tissue ◽  
Left Ventricular Outflow ◽  
Accessory Mitral Valve Tissue

scholarly journals Subaortic stenosis and mitral dysplasia in three Black Russian Terrier puppies

2012 ◽  
Vol 50 (No. 7) ◽  
pp. 321-326
Author(s):  
J. Pikula ◽  
J. Pikulova ◽  
H. Bandouchova ◽  
P. Kohout ◽  
K. Najman ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Aortic Stenosis ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Subaortic Stenosis ◽  
Maximum Pressure ◽  
Mitral Insufficiency ◽  
Left Ventricular Outflow

A combined congenital heart defect of aortic stenosis and mitral dysplasia was diagnosed in three Black Russian Terrier puppies two months old. The aortic stenosis component included both fixed and dynamic obstructions. The fixed obstruction was subvalvularly located at the entrance to the left ventricular outflow tract. The dynamic obstruction was caused by the septal leaflet of the mitral valve protruding into the left ventricular outflow tract. Mitral dysplasia resulted in mitral insufficiency leading to regurgitation through the mitral valve closer to the septal side. The maximum pressure gradient across the aortic valve amounting to 103 mmHg measured in one puppy was consistent with the most severe grade of stenosis. The diagnosis was confirmed by autopsy in all three puppies that were males and originated in one litter, so genetic influences are supposed.

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