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Left Ventricular Outflow Tract Obstruction From Preserved Leaflet After Mitral Valve Replacement
Iosif Gulkarov1, Mukund Das2, Krystyna Bronchard2
1Department of Cardiothoracic Surgery, Staten Island University Hospital, Staten Island, New York.
The Annals of Thoracic Surgery
|December 22, 2019
Summary
A rare cause of left ventricular outflow tract obstruction (LVOTO) is the anterior mitral valve leaflet after replacement. Surgical excision of the remaining leaflet corrected the obstruction and improved heart failure.
Area of Science:
- Cardiology
- Cardiac Surgery
Background:
- Left ventricular outflow tract obstruction (LVOTO) is a critical condition with diverse etiologies.
- Mitral valve replacement can rarely lead to LVOTO due to residual native valve structures.
Observation:
- A patient presented with worsening chronic congestive heart failure.
- The cause was identified as LVOTO resulting from systolic anterior motion of the preserved native anterior mitral leaflet.
Findings:
- The systolic anterior motion of the residual anterior mitral leaflet created significant LVOTO.
- This rare complication occurred post-mitral valve replacement.
Implications:
- Surgical excision of the anterior mitral leaflet and chordal apparatus via the aortic root is an effective treatment.
- This approach can successfully correct LVOTO and alleviate heart failure symptoms in select cases.
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