The 'Pomeroy procedure': A new method to correct post-mitral valve repair systolic anterior motion

Systolic anterior motion (SAM), a recognized complication of mitral valve r epair, is often associated with left ventricular outflow gradient and mitra l regurgitation. Current surgery to prevent these conditions is to perform sliding annuloplasty to reduce the posterior mitral leaflet (PML) height an d to oversize the annuloplasty ring. However, these techniques do not consi stently eliminate post-repair SAM, and removal of excess tissue and reducti on of anterior mitral leaflet (AML) height may be more effective; this is t he 'Pomeroy procedure'. Here, we report a patient in whom all standard proc edures to prevent SAM were performed, but the condition still developed. Th is was corrected on a second pump run, using the Pomeroy procedure.