title: Left ventricular pacing can be a complementary solution for systolic anterior motion after mitral valve plasty.
abstract: A 54-year old man underwent redo mitral valve (MV) plasty because of recurrent mitral regurgitation (MR). Intraoperative transoesophageal echocardiography revealed severe MR and turbulent flow at the left ventricular (LV) outflow tract associated with systolic anterior motion of the MV. Various medical treatments, additional surgical correction, and atrial and right ventricular pacing had failed to resolve the MR associated with systolic anterior motion. LV pacing, however, markedly attenuated MR. Temporary LV pacing was discontinued on postoperative day 2, and subsequently MR associated with systolic anterior motion has not recurred. LV dyssynchrony resulting from conduction disturbances might cause systolic anterior motion immediately after MV plasty. We speculate that LV pacing eliminated LV dyssynchrony and improved the MR associated with systolic anterior motion. Temporary LV pacing can be performed easily and safely at the time of MV plasty. LV pacing can be a complementary treatment for systolic anterior motion and resultant MR.
authors.affiliation: Department of Cardiovascular Surgery, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Ushijima
authors.affiliation: Department of Cardiovascular Surgery, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan tnishida@heart.med.kyushu-u.ac.jp.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Nishida
authors.affiliation: Department of Cardiovascular Surgery, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
authors.forename: Meikun
authors.initials: M
authors.lastname: Kan-O
authors.affiliation: Department of Cardiovascular Surgery, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
authors.forename: Ryuji
authors.initials: R
authors.lastname: Tominaga
mesh_terms: D002304:Cardiac Pacing, Artificial / Q000379:methods*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology / Q000601:surgery; D008944:Mitral Valve Insufficiency / Q000503:physiopathology / Q000601:surgery / Q000628:therapy; D012086:Reoperation; D013599:Systole; D014463:Ultrasonography
keywords: Left ventricular pacing; Mitral regurgitation; Mitral valve repair; Systolic anterior motion