title: Echocardiographic diagnosis of left ventricular outflow tract obstruction after mitral valve replacement with subvalvular preservation.
abstract: 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.
authors.affiliation: Department of Anesthesiology, University Hospital Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands. g.w.rietman@anest.azg.nl
authors.forename: G W
authors.initials: GW
authors.lastname: Rietman
authors.forename: J M A A
authors.initials: JM
authors.lastname: van der Maaten
authors.forename: Y L
authors.initials: YL
authors.lastname: Douglas
authors.forename: P W
authors.initials: PW
authors.lastname: Boonstra
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D017548:Echocardiography, Transesophageal; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D014694:Ventricular Outflow Obstruction / Q000000981:diagnostic imaging* / Q000209:etiology