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Anesth Analg 2004;99:38-40
© 2004 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000117281.95170.24

CARDIOVASCULAR ANESTHESIA

An Unusual Cause of Left Ventricular Outflow Tract Obstruction After Mitral Valve Repair

Kathryn E. Glas, MD*, Jack S. Shanewise, MD*, and Robert A. Guyton, MD{dagger}

Departments of *Anesthesiology and {dagger}Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, Georgia

Address correspondence and reprint requests to Kathryn E. Glas, MD, Department of Anesthesiology, 550 Peachtree St., Atlanta, GA 30308. Address e-mail to kathryn_glas{at}emoryhealthcare.org

Left ventricular outflow tract (LVOT) obstruction caused by systolic anterior motion is a cause of failed mitral valve repair. Intraoperative transesophageal echocardiography has been very helpful in diagnosing problems with mitral valve repairs intraoperatively, allowing immediate correction. We report an unusual cause of LVOT obstruction attributed to prolapse of the annuloplasty ring into the LVOT. Intraoperative hemodynamics were normal, and the diagnosis would not have been made before leaving the operative suite without the transesophageal echocardiography.

IMPLICATIONS: The authors describe the intraoperative diagnosis of an unusual cause of left ventricular outflow obstruction in a patient with normal hemodynamic status after mitral valve repair.




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K. Bendjelid, K. E. Glas, and J. S. Shanewise
ECG Monitoring Is Essential for Echocardiographic Analysis * Response
Anesth. Analg., January 1, 2005; 100(1): 294 - 296.
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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2004 by the International Anesthesia Research Society.