Reversibility systolic anterior motion of the mitral valve after aortic valve replacement for severe aortic stenosis

Abstract

Key Clinical Message Patients with aortic valve replacement (AVR) for severe aortic stenosis (AS) will cause reversibility systolic anterior motion (SAM). This may occur because of afterload reduction caused by the relief of the AS and the prolonged anterior mitral valve. It is important to evaluate the mechanism of SAM by intraoperative real‐time transesophageal echocardiography (TEE). Abstract This case video describes the presentation and successful treatment of a 58‐year‐old man who experienced post‐AVR SAM with dynamic (left ventricle outflow tract) LVOT obstruction. This case highlights the fact that patients with AVR for severe AS may cause reversible SAM. This may occur because of afterload reduction caused by the relief of the AS combined with the prolonged anterior mitral valve. It is important to evaluate the mechanism of SAM by intraoperative real‐time TEE and then make the surgical decision.

Keywords

• aortic stenosis
• aortic valve replacement
• reversibility
• systolic anterior motion