Predicting systolic anterior motion after mitral valve reconstruction: using intraoperative transoesophageal echocardiography to identify those at greatest risk.
Robin Varghese, MD, Shinobu Itagaki, MD, Anelechi C. Anyanwu, MD, Paula Trigo, MD, Gregory Fischer, MD and David H. Adams, MD
Systolic anterior motion (SAM) is reported to occur in 4-10% of cases after mitral valve repair (MVR) [1-3]. A number of surgical techniques have been suggested to decrease the incidence of SAM after MVR [3, 4]. Knowing which patients are at an increased risk for developing SAM at the time of repair may provide the surgeon with guidance as to the specific repair strategy they should employ. However, those factors that predispose patients to SAM have only been studied in limited detail. Small series and case reports have suggested some predictive factors, such as anterior/posterior leaflet ratios and coaptation point to septal distance as predictive of SAM [5, 6]. However, because of limited sample size, mixed aetiologies and non-consecutive patient inclusion, published studies generally do not provide a robust and objective analysis of predictors for SAM. Hence, the aim of this study was to assess the role of the mitral valve (MV) apparatus, ventricular dimensions and ventricular function in predicting SAM in patients undergoing MVR for degenerative disease.
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Publications
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Transcatheter Repair for Patients with Tricuspid Regurgitation
Paul Sorajja, MD, Brian Whisenant, MD, David H. Adams, MD, et al. -
Failure to Rescue: A Quality Metric for Cardiac Surgery and Cardiovascular Critical Care
Caroline R Gross, David H Adams, Parth Patel, Robin Varghese -
Research Opportunities in the Treatment of Mitral Valve Prolapse: JACC Expert Panel
Francesca N Delling, Peter A Noseworthy, David H Adams, et al. -
Plasma Renin Activity Increases With Cardiopulmonary Bypass and is Associated With Vasoplegia After Cardiac Surgery
Morgan L Montgomery, Caroline R Gross, Hung-Mo Lin, Yuxia Ouyang, Matthew A Levin, Holly E Corkill, Ahmed El-Eshmawi, David H Adams, Menachem M Weiner