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Abstract
The exponential growth of mitral repair surgery has transformed the prognosis of
patients with severe mitral regurgitation. All expert consensus and current clinical
guidelines recognize the preponderance of mitral reconstruction. The incidence of
complications inherent to more conservative repair techniques, such as systolic anterior
motion (SAM), has also increased. The mechanisms of SAM are complex and depend
directly on the characteristics of the mitral apparatus after plasty and, of course, on
the hemodynamic state of the left ventricle. In this context, echocardiography has an
important diagnostic and prognostic role. Approximately 90% of cases of SAM can be
resolved conservatively; therefore, an orderly multidisciplinary approach is critical in
understanding the substrate of the problem and knowing when and how to intervene.
A simple algorithm for the management of perioperative MAS is presented below.
References
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