Glines Katelyn, Hayanga J W Awori, Gibson Christina, El Churafa Mohamad, Wei Lawrence, Hayanga Heather K
West Virginia University Hospitals, Department of Anesthesiology, Medical Center Drive, Morgantown 26505, WV, USA.
West Virginia University Hospitals, Department of Cardiovascular and Thoracic Surgery, Medical Center Drive, Morgantown 26505, WV, USA.
Case Rep Anesthesiol. 2023 Mar 17;2023:9995115. doi: 10.1155/2023/9995115. eCollection 2023.
Systolic anterior motion (SAM) describes a pathologic condition of the mitral valve in which the anterior leaflet is displaced anteriorly, resulting in a narrowed left ventricular outflow tract (LVOT). The implications of SAM may range in severity from clinically insignificant disease to severe LVOT obstruction resulting in hemodynamic collapse. While SAM is typically observed in patients with hypertrophic cardiomyopathy or following mitral valve repair, it may be seen in any setting in which the anatomy and function of the left ventricle has been altered. Here we discuss two patients who presented for aortic and mitral valve replacements for concomitant aortic and mitral stenosis. These cases were further complicated by the preoperative diagnosis of SAM in addition to the preexisting valvular lesions, further increasing the risk of sudden hemodynamic collapse and cardiac arrest.
收缩期前向运动（SAM）描述了一种二尖瓣的病理状态，即前叶向前移位，导致左心室流出道（LVOT）变窄。SAM的影响严重程度不一，从临床上无明显意义的疾病到导致血流动力学崩溃的严重LVOT梗阻。虽然SAM通常在肥厚型心肌病患者或二尖瓣修复术后观察到，但在任何左心室解剖结构和功能发生改变的情况下都可能出现。在此，我们讨论两名因主动脉瓣和二尖瓣狭窄同时进行主动脉瓣和二尖瓣置换术的患者。除了原有的瓣膜病变外，这些病例术前还被诊断为SAM，这进一步增加了突然血流动力学崩溃和心脏骤停的风险。
