Echocardiographic Correlates of Left Ventricular Outflow Obstruction and Systolic Anterior Motion following Mitral Valve Repair
Pravin M. Shah MD, Aidan A. Raney MD

The study examines role of measured anterior and posterior leaflet heights (or elongation) by intraoperative transesophageal echocardiography (TEE) in development of post mitral repair systolic anterior motion (SAM) and outflow obstruction. Eight patients with SAM (SAM group) were compared with 32 patients without (No-SAM group). A striking disparity between reconstructed annular size and excess anterior leaflet height was noted in the SAM group. Combined anterior and posterior leaflet heights relative to annular size were disproportionately much larger in the SAM group than in the No-SAM group. Clinical implications for prevention of SAM are discussed.