Key result
Landiolol resolves SAM after mitral valve repair in 3 cases.
Why the study?
Preoperative mitral valve morphology is a risk factor for systolic anterior motion (SAM) after mitral valve plasty, but detailed morphological analysis and predictive markers need further elucidation.
Case Report (n=3)
No
Preoperative transesophageal echocardiography can identify specific morphological characteristics, such as a small distance between coaptation and the interventricular septum, in patients who develop systolic anterior motion after mitral valve repair.
Landiolol may resolve post-repair SAM in select cases; leaves open need for prospective trials before clinical adoption.
We report three cases with systolic anterior motion (SAM) after mitral valve plasty. Preoperative mitral valve morphology is a risk factor for SAM. The morphological characteristics of SAM have been revealed in several studies. We found a small distance between coaptation and the interventricular septum in all cases, and cases 2, and 3 had a low AL/PL ratio, whereas case 3 had a large PML, which was revealed by transesophageal echocardiography. With the use of 3D transesophageal echocardiography, when mitral valve prolapse was investigated, in all three cases, it was easy to specify lesions. The issue for the future is 3D analysis when SAM is occurring.
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Yoshimura et al. (2013) conducted a case report in Systolic anterior motion (SAM) after mitral valve repair (n=3). Landiolol was evaluated on Disappearance of SAM and predicted plasma landiolol concentration. In three cases of systolic anterior motion after mitral valve repair, administration of landiolol successfully resolved the condition, with predicted plasma concentrations at disappearance ranging from 0.22 to 0.40 µg/ml.
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