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Echocardiographic diagnosis of left ventricular outflow tract obstruction after mitral valve replacement with subvalvular preservation.
Authors:G W Rietman  J M A A van der Maaten  Y L Douglas  P W Boonstra
Institution:Department of Anesthesiology, University Hospital Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands. g.w.rietman@anest.azg.nl
Abstract:We describe two cases of left ventricular outflow tract obstruction after mitral valve replacement with complete retention of the subvalvular apparatus. The first patient deteriorated immediately after insertion of a high-profile bioprosthesis. In the second patient, chronic left ventricular outflow tract obstruction developed after the insertion of a low-profile mechanical prosthesis. The clinical course of left ventricular outflow tract obstruction after mitral valve replacement with complete retention of the subvalvular apparatus may differ greatly. Evaluation of the left ventricular outflow tract by perioperative transesophageal echocardiography or epicardial echocardiography is essential in the prevention and treatment of this complication.
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