A short-acting beta-blocker, landiolol, attenuates systolic anterior motion of the mitral valve after mitral valve annuloplasty.
Here, we describe three patients with severe hemodynamic instability after mitral valve annuloplasty (MVP) who were treated successfully using a new ultra-short-acting beta-blocker, landiolol hydrochloride. When systolic anterior motion (SAM) of the mitral valve occurs after MVP, left ventricular outflow tract obstruction (LVOTO) and mitral regurgitation (MR) often lead to hemodynamic collapse. Treatment of SAM is very difficult, and transfusion, or the reduction/discontinuation of catecholamine or vasopressor administration, is often ineffective. In our three patients, landiolol hydrochloride decreased the heart rate, markedly attenuated SAM, and improved the hemodynamics. We recommend that landiolol be administered before further surgical manipulation is considered in patients with SAM after MVP.
Omae
Takeshi
T
Department of Anesthesiology and Critical Care Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan.
Tsuneyoshi
Isao
I
Higashi
Akiko
A
Matsunaga
Akira
A
Sakata
Ryuzo
R
Kanmura
Yuichi
Y
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology*; D000368:Aged; D005260:Female; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000187:drug effects*; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D009025:Morpholines / Q000494:pharmacology*; D013599:Systole; D016896:Treatment Outcome; D014508:Urea / Q000031:analogs & derivatives* / Q000494:pharmacology
D000319:Adrenergic beta-Antagonists; D009025:Morpholines; C077049:landiolol; D014508:Urea