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Updated: Aug 11, 2026

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
Systolic Anterior Motion and Dynamic Mitral Regurgitation Following SAVR: A Case of Hemodynamic Optimization Over
Teresa Farella1, Andrea Faggiano2, Elisa Gherbesi2
1Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
Abstract:
Mitral regurgitation (MR) frequently coexists with severe aortic stenosis and may persist or worsen after surgical aortic valve replacement (SAVR) despite afterload reduction. Following SAVR, abrupt ventricular unloading can unmask hyperdynamic ventricular function, promote systolic anterior motion and left ventricular outflow tract (LVOT) obstruction, resulting in dynamic MR and hemodynamic instability. A thorough preoperative assessment of ventricular geometry and mitral valve anatomy is crucial to identify patients at increased risk of post-SAVR LVOT obstruction. We describe a case of severe dynamic MR and LVOT obstruction following SAVR, successfully managed through comprehensive echocardiographic evaluation and tailored hemodynamic optimization, ultimately avoiding unnecessary percutaneous mitral intervention.
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