title: Systolic Anterior Motion Obstructing the Pulmonary Outflow Tract After Tricuspid Valve Replacement.
abstract: A patient with congenitally corrected transposition of the great arteries who presented with shortness of breath was found to have severe tricuspid regurgitation and right ventricular impairment. After uneventful mechanical systemic tricuspid atrioventricular valve replacement, the patient was extubated within 12 hours. On the first postoperative day, he developed episodes of profound hypotension lasting a few seconds. A transesophageal echocardiogram demonstrated displacement of the interventricular septum that caused systolic anterior motion of the mitral valve into the subpulmonic left ventricle. Mitral valve replacement resolved this complication, and the patient proceeded to do well at discharge.
authors.affiliation: Department of Cardiothoracic Surgery, Manchester Royal Infirmary, Central Manchester Foundation NHS Trust, Manchester, United Kingdom.
authors.forename: Bilal H
authors.initials: BH
authors.lastname: Kirmani
authors.affiliation: Department of Cardiothoracic Anaesthesia, Manchester Royal Infirmary, Central Manchester Foundation NHS Trust, Manchester, United Kingdom.
authors.forename: Ijas
authors.initials: I
authors.lastname: Moideen
authors.affiliation: Department of Cardiothoracic Anaesthesia, Manchester Royal Infirmary, Central Manchester Foundation NHS Trust, Manchester, United Kingdom.
authors.forename: Pedro
authors.initials: P
authors.lastname: Fernandez-Jimenez
authors.affiliation: Department of Cardiothoracic Anaesthesia, Manchester Royal Infirmary, Central Manchester Foundation NHS Trust, Manchester, United Kingdom.
authors.forename: Martin
authors.initials: M
authors.lastname: Bewsher
authors.affiliation: Department of Cardiology, Manchester Royal Infirmary, Central Manchester Foundation NHS Trust, Manchester, United Kingdom.
authors.forename: Jaspal
authors.initials: J
authors.lastname: Dua
authors.affiliation: Department of Cardiology, Manchester Royal Infirmary, Central Manchester Foundation NHS Trust, Manchester, United Kingdom.
authors.forename: Petra
authors.initials: P
authors.lastname: Jenkins
authors.affiliation: Department of Cardiothoracic Surgery, Manchester Royal Infirmary, Central Manchester Foundation NHS Trust, Manchester, United Kingdom. Electronic address: andreas.hoschtitzky@cmft.nhs.uk.
authors.forename: J Andreas
authors.initials: JA
authors.lastname: Hoschtitzky
mesh_terms: D000328:Adult; D001705:Bioprosthesis; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000379:methods; D002315:Cardiopulmonary Bypass / Q000379:methods; D017548:Echocardiography, Transesophageal / Q000379:methods; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D012086:Reoperation / Q000379:methods; D018570:Risk Assessment; D056346:Sternotomy / Q000379:methods; D013599:Systole / Q000502:physiology; D014188:Transposition of Great Vessels / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome; D014262:Tricuspid Valve Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery*; D014694:Ventricular Outflow Obstruction / Q000000981:diagnostic imaging / Q000601:surgery*