Key result
Mitral valve replacement with complete retention of the subvalvular apparatus caused left ventricular outflow tract obstruction in 2 reported cases, requiring perioperative echocardiographic evaluation.
Case Report (n=2)
Perioperative transesophageal or epicardial echocardiography is essential for detecting left ventricular outflow tract obstruction after mitral valve replacement with subvalvular preservation.
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May warrant perioperative echocardiography after MVR with subvalvular preservation; case reports leave open prospective confirmation of risk.
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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Rietman et al. (2002) conducted a case report in Left ventricular outflow tract obstruction (n=2). Mitral valve replacement with complete retention of the subvalvular apparatus was evaluated on Left ventricular outflow tract obstruction. Mitral valve replacement with complete retention of the subvalvular apparatus caused left ventricular outflow tract obstruction in 2 reported cases, requiring perioperative echocardiographic evaluation.
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