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Ann Thorac Surg 1994;57:484-486
© 1994 The Society of Thoracic Surgeons

Articles

Systolic anterior motion of the mitral valve after valve repair without an annular ring

John P. Kupferschmid, MD, Thomas Carr, MD, Gilbert P. Connelly, MD, Richard J. Shemin, MD*

Departments of Cardiothoracic Surgery and Anesthesia, The University Hospital, Boston University Medical Center, Boston, Massachusetts, USA

Accepted for publication May 27, 1993.

* Address reprint requests to Dr Shemin, Department of Cardiac Surgery, The University Hospital, Boston University Medical Center, 88 E Newton St. Boston, MA 02118.

A 78-year-old woman underwent mitral reconstruction, consisting of a quadrangular posterior leaflet resection without a concomitant annular ring, for symptomatic mitral regurgitation. Postoperatively she became hypotensive while being treated with dopamine. Transesophageal echocardiography revealed systolic anterior motion of the mitral valve with significant mitral regurgitation. With discontinuation of the dopamine regimen, institution of phenylephrine administration, and volume loading of the ventricle the systolic anterior motion disappeared as did the mitral regurgitation. The patient recovered uneventfully.




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