Unmasking Severe Systolic Anterior Motion With Left Ventricular Outflow Tract Obstruction Following Mitral Valve Repair

Michel Chedid El Helou; Mariya Geube; Shinya Unai; Nicholas Smedira; Brian Griffin; Patrick Collier

doi:10.1016/j.jaccas.2024.102258

Unmasking Severe Systolic Anterior Motion With Left Ventricular Outflow Tract Obstruction Following Mitral Valve Repair

JACC Case Rep. 2024 Mar 25;29(9):102258. doi: 10.1016/j.jaccas.2024.102258. eCollection 2024 May 1.

Authors

Michel Chedid El Helou¹, Mariya Geube², Shinya Unai³, Nicholas Smedira³, Brian Griffin¹, Patrick Collier¹

Affiliations

¹ Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
² Department of Cardiothoracic Anesthesiology, Cleveland Clinic, Cleveland, Ohio, USA.
³ Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio, USA.

Abstract

A 38-year-old male with a history of myxomatous mitral valve disease post-repair presented with recurrent dyspnea during exertion. Initial evaluation showed mild systolic anterior motion and mitral regurgitation, but medical management was unsuccessful. The patient underwent reoperation; intraoperative transesophageal echocardiogram with provocation unmasked severe systolic anterior motion and torrential mitral regurgitation.

Keywords: left ventricular outflow tract obstruction; mitral regurgitation; mitral valve; systolic anterior motion; transesophageal echocardiography.

Publication types

Case Reports