Left ventricular outflow obstruction: a complication of mitral valvuloplasty

Thirty-two patients with severe mitral regurgitation underwent Carpentier mitral valvuloplasty. Postoperatively, three of these patients developed clinical and echocardiographic evidence of left ventricular outflow tract obstruction. None of these patients had asymmetric septal hypertrophy or preoperative echocardiographic demonstration of systolic anterior motion of the mitral valve. Outflow obstruction postoperatively was caused by systolic anterior motion of the mitral valve. Because this potential complication of Carpentier mitral valvuloplasty produced significant hemodynamic effects in two patients, echocardiography should be routinely performed after this operation.