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

IF 3.6 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Critical Ultrasound Journal Pub Date : 2018-11-12 DOI:10.1186/s13089-018-0111-6
Yusuke Seino, Nobuo Sato, Kimiya Fukui, Junya Ishikawa, Masahi Nakagawa, Takeshi Nomura
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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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重症监护室二尖瓣修复后短暂性收缩前运动伴结膜节律。
二尖瓣修复(MVR)后的收缩前运动(SAM)会加重左心室流出道阻塞和二尖瓣反流,从而对血流动力学产生不利影响。在经食管超声心动图(TEE)连续监测下,MVR术后术中短暂性SAM通常可以通过血流动力学操作来控制。然而,在术后重症监护管理期间,短暂性SAM很少被诊断出来,并且可能延迟治疗的开始。我们在重症监护室(ICU)报告一例MVR后短暂性SAM,由于连接节律突然恶化。TEE显示从正常窦性心律到结性心律的转变导致SAM加重。TEE可用于识别ICU心脏手术后不稳定血流动力学的病因,类似于其在手术室的应用。
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Critical Ultrasound Journal
Critical Ultrasound Journal RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
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