SYSTOLIC ANTERIOR MOTION OF THE MITRAL-VALVE AFTER VALVE REPAIR WITHOUT AN ANNULAR RING

A 78-year-old woman underwent mitral reconstruction, consisting of a q uadrangular posterior leaflet resection without a concomitant annular ring, for symptomatic mitral regurgitation. Postoperatively she became hypotensive while being treated with dopamine. Transesophageal echoca rdiography revealed systolic anterior motion of the mitral valve with significant mitral regurgitation. With discontinuation of the dopamine regimen, institution of phenylephrine administration, and volume load ing of the ventricle the systolic anterior motion disappeared as did t he mitral regurgitation. The patient recovered uneventfully.