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Open Access 01-12-2018 | Case report

Transient systolic anterior motion with junctional rhythm after mitral valve repair in the intensive care unit

Authors: Yusuke Seino, Nobuo Sato, Kimiya Fukui, Junya Ishikawa, Masahi Nakagawa, Takeshi Nomura

Published in: The Ultrasound Journal | Issue 1/2018

Abstract

Systolic anterior motion (SAM) after mitral valve repair (MVR) can adversely affect hemodynamics due to exacerbation of left ventricular outflow tract obstruction and mitral regurgitation. Intraoperative transient SAM after MVR can usually be managed with hemodynamic maneuvers under continuous monitoring by transesophageal echocardiography (TEE). However, during postoperative intensive care management, transient SAM is seldom diagnosed and the start of treatment may be delayed. We present a case of transient SAM after MVR with abrupt deterioration due to junctional rhythm in the intensive care unit (ICU). TEE revealed that conversion from normal sinus rhythm into junctional rhythm induced the exacerbation of SAM. TEE was useful for identifying the etiology of unstable hemodynamics after cardiac surgery in the ICU, similar to its use in the operating room.

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Title: Transient systolic anterior motion with junctional rhythm after mitral valve repair in the intensive care unit
Authors: Yusuke Seino
Nobuo Sato
Kimiya Fukui
Junya Ishikawa
Masahi Nakagawa
Takeshi Nomura
Publication date: 01-12-2018
Publisher: Springer Milan
Published in: The Ultrasound Journal / Issue 1/2018
Electronic ISSN: 2524-8987
DOI: https://doi.org/10.1186/s13089-018-0111-6

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