Korean J Anesthesiol.  2007 Aug;53(2):242-245. 10.4097/kjae.2007.53.2.242.

Perioperative Hypotension due to Systolic Anterior Motion of the Mitral Valve with Left Ventricular Outflow Track Obstruction during Off-Pump Coronary Artery Bypass Surgery: A case report

• Seol TK
• Lee JH
• Yoon SZ
• Jeon YS
• Bahk JH
• Kim KB
• Kim CS

• KMID: 2243382
• DOI: http://doi.org/10.4097/kjae.2007.53.2.242

Abstract

Systolic anterior motion of the mitral valve (SAM) is well known in the concentric left ventricular hypertrophy or post mitral valvuloplasty. However, SAM has not been reported in Off-pump coronary artery bypass surgery (OPCAB). Preoperatively, SAM in combination with a left ventricular outflow tract obstruction leads to severe cardiovascular destabilization. Moreover, a diagnosis of SAM is very important because the administration of conventional therapy to hypotension can aggravate SAM. We report a patient with un-identified left ventricular wall hypertrophy or mitral valve regurgitation, who was diagnosed with SAM by TEE during OPCAB. This report describes the diagnostic and therapeutic strategies for the perioperative management of SAM.

Keyword

hypotension; off-pump coronary artery bypass surgery; systolic anterior motion of mitral leaflet

MeSH Terms

Coronary Artery Bypass, Off-Pump*
Diagnosis
Humans
Hypertrophy
Hypertrophy, Left Ventricular
Hypotension*
Mitral Valve Insufficiency
Mitral Valve*