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.
10.4097/kjae.2007.53.2.242
- Author:
Tai Kyung SEOL
1
;
Jong Hwan LEE
;
Seung Zhoo YOON
;
Yun Seok JEON
;
Jae Hyon BAHK
;
Ki Bong KIM
;
Chong Sung KIM
Author Information
1. Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea. otter128@snuh.org
- Publication Type:Case Report
- Keywords:
hypotension;
off-pump coronary artery bypass surgery;
systolic anterior motion of mitral leaflet
- MeSH:
Coronary Artery Bypass, Off-Pump*;
Diagnosis;
Humans;
Hypertrophy;
Hypertrophy, Left Ventricular;
Hypotension*;
Mitral Valve Insufficiency;
Mitral Valve*
- From:Korean Journal of Anesthesiology
2007;53(2):242-245
- CountryRepublic of Korea
- Language:Korean
-
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.
