Systolic anterior motion. A report of two cases
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Date
2012
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SOC MEDICA SANTIAGO
Abstract
Systolic anterior motion describes the anterior displacement of one or both mitral valve leaflets, obstructing the outflow tract of the left ventricle. It can be a cause of severe hypotension during the intraoperative and postoperative period of non-cardiac surgery. The diagnosis is made with echocardiography. We report two patients with this problem. The first was a 74-year-old male subjected to an incisional hernia repair who presented severe hypotension in the intraoperative period. A transesophageal echocardiography revealed an anterior displacement of the mitral valve anterior leaflet. Epinephrine was discontinued and Norepinephrine and a volume expander were administered, with good response. The second patient was a 64-year-old male undergoing a right liver lobectomy. In the postoperative period, he suffered severe hypotension. A transesophageal echocardiography revealed an anterior displacement of the mitral valve anterior leaflet. Dobutamine was discontinued, volume was administered, and a Norepinephrine infusion was started with good response. (Rev Med Chile 2012; 140: 1046-1049).
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Keywords
Hypotension, Mitral valve, Postoperative period, OUTFLOW TRACT OBSTRUCTION, LEFT-VENTRICULAR FUNCTION, NONCARDIAC SURGERY, MITRAL-VALVE, ECHOCARDIOGRAPHY