OUTFLOW TRACT OBSTRUCTION AFTER MITRAL-VALVE REPAIR WITHOUT AN ANNULOPLASTY RING

We report that systolic anterior motion of the mitral valve with signi ficant left ventricular outflow tract obstruction can occur after mitr al valve reconstruction without using an annuloplasty ring, A 69-year- old male patient with mitral regurgitation and ischemic heart disease underwent combined mitral valve reconstruction without an annuloplasty ring, and coronary artery bypass grafting, Intraoperative transesopha geal echocardiography performed at the end of the operation revealed s ystolic anterior motion of the mitral valve with significant outflow t ract obstruction requiring a second pump run with return to cardiopulm onary bypass and additional mitral valve replacement during the same t horacotomy.