Abstract

CONCHA, Mario  and  MERTZ K, Verónica. Systolic anterior motion: A report of two cases. Rev. méd. Chile [online]. 2012, vol.140, n.8, pp.1046-1049. ISSN 0034-9887.  http://dx.doi.org/10.4067/S0034-98872012000800012.

Background: 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.

Keywords : Hypotension; Mitral valve; Postoperative period.

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