Department of Cardiac Surgery, IRCCS Policlinico San Donato, Milan, Italy.
Department of Cardiac Surgery Medical University of Innsbruck Austria.
Multimed Man Cardiothorac Surg. 2024 Sep 24;2024. doi: 10.1510/mmcts.2024.060.
Systolic anterior motion is characterized by the displacement of the anterior mitral leaflet towards the left ventricle outflow tract. Iatrogenic systolic anterior motion occurs after mitral valve repair as a result of mitral annuloplasty. Possible causes include excess height of a redundant posterior mitral leaflet and/or the use of an undersized ring. The condition is usually diagnosed after weaning from cardiopulmonary bypass by transoesophageal echocardiography. Apart from conservative measures, the treatment of systolic anterior motion may require the restoration of cardiopulmonary bypass and further surgical valve repair. Strategies for systolic anterior motion correction include an edge-to-edge repair or the use of a larger annuloplasty ring. In this tutorial, we present two ways of reducing posterior leaflet height as a simple option to move the leaflet coaptation more posteriorly.
收缩期前向运动的特征是二尖瓣前叶向左心室流出道移位。二尖瓣修复术后，由于二尖瓣环成形术，会发生医源性收缩期前向运动。可能的原因包括多余的二尖瓣后叶高度过高和/或使用过小的环。这种情况通常在经食管超声心动图从体外循环脱机后诊断。除了保守治疗外，收缩期前向运动的治疗可能需要恢复体外循环并进一步进行瓣膜修复手术。治疗收缩期前向运动的策略包括采用瓣缘对缘修复或使用更大的环成形术环。在本教程中，我们提出了两种降低后叶高度的方法，作为将瓣叶对合更向后移动的简单选择。
