From Severe Aortic Stenosis to Mitral TEER: Overcoming Surgical AVR Complicated With LVOTO.

ABSTRACT:

Background

Systolic anterior motion (SAM) and dynamic left ventricular outflow tract obstruction (LVOTO) is a well-described phenomenon in hypertrophic obstructive cardiomyopathy and rarely reported after surgical aortic valve replacement (AVR).

Case summary

We present the first reported case of SAM and LVOTO developing intraoperatively after surgical AVR for severe bicuspid aortic valve stenosis necessitating mitral transcatheter edge-to-edge repair (TEER) with the MitraClip. Optimal titration of pharmacologic management was not sufficient to relieve LVOTO in our patient.

Why beyond the guidelines

Despite management following conventional guidelines, the patient remained in critical condition. TEER with the MitraClip led to a reduction in SAM and optimization of his

SUBMITTER: Heller TM 

PROVIDER: S-EPMC12441389 | biostudies-literature | 2025 Jul

REPOSITORIES: biostudies-literature