Validation of a decision-making strategy for systolic anterior motion following mitral valve repair.
Ann Card Anaesth
; 2011 May; 14(2): 85-90
Article
em En
| IMSEAR
| ID: sea-139579
ABSTRACT
Low cardiac output syndrome and hypotension are dreadful consequences of systolic anterior motion (SAM) after a mitral valve (MV) repair. The management of SAM in the operating room remains controversial. We validate a recently suggested two-step management method and classification of this complication. This was a teaching hospital-based observational study. We validated a novel two-step conservative management method, consisting in intravascular volume expansion and discontinuation of inotropic drugs (step 1), and increasing the afterload by ascending aorta manual compression while administering esmolol e.v. (step 2). We also validate a novel classification of SAM easy-to-revert (responding to step 1), difficult-to-revert (responding to step 2), or persistent. Fifty patients had an easy-to-revert while 26 had a difficult-to-revert SAM; 4 patients had a persistent condition (promptly diagnosed through our decisional algorithm) and underwent an immediate second pump run to repeat the mitral repair surgery. We confirmed that SAM after a repair of a degenerative MV is common and validated a simple two-step conservative management method that allows to clearly identify those few patients who require immediate surgical revision.
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Texto completo:
1
Índice:
IMSEAR
Assunto principal:
Propanolaminas
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Reoperação
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Sístole
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Idoso
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Feminino
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Humanos
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Masculino
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Próteses Valvulares Cardíacas
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Ponte Cardiopulmonar
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Reprodutibilidade dos Testes
Tipo de estudo:
Guideline
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Observational_studies
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Prognostic_studies
Idioma:
En
Revista:
Ann Card Anaesth
Ano de publicação:
2011
Tipo de documento:
Article