title: [Systolic anterior motion: a report of two cases].
abstract: Systolic anterior motion describes the anterior displacement of one or both mitral valve leaflets, obstructing the outflow tract of the left ventricle. It can be a cause of severe hypotension during the intraoperative and postoperative period of non-cardiac surgery. The diagnosis is made with echocardiography. We report two patients with this problem. The first was a 74-year-old male subjected to an incisional hernia repair who presented severe hypotension in the intraoperative period. A transesophageal echocardiography revealed an anterior displacement of the mitral valve anterior leaflet. Epinephrine was discontinued and Norepinephrine and a volume expander were administered, with good response. The second patient was a 64-year-old male undergoing a right liver lobectomy. In the postoperative period, he suffered severe hypotension. A transesophageal echocardiography revealed an anterior displacement of the mitral valve anterior leaflet. Dobutamine was discontinued, volume was administered, and a Norepinephrine infusion was started with good response.
authors.affiliation: División de Anestesiología, Escuela de Medicina, Hospital Clínico, Pontificia Universidad Católica de Chile, Chile.
authors.forename: Mario
authors.initials: M
authors.lastname: Concha
authors.forename: Verónica
authors.initials: V
authors.lastname: Mertz K
mesh_terms: D000368:Aged; D059685:Herniorrhaphy; D006801:Humans; D007022:Hypotension / Q000209:etiology*; D007431:Intraoperative Complications; D008099:Liver / Q000601:surgery; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging; D011183:Postoperative Complications; D012720:Severity of Illness Index; D014463:Ultrasonography