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Jan 18, 2012 · We propose that medical therapy should be used to stabilize the patient and to adequately assess the degree of SAM and MR. If there is only mild SAM and MR, then medical therapy should be used. However, in moderate or worse SAM and MR, we propose that even if medical therapy is able to abolish SAM, a surgical solution should be sought.
- Michael Ibrahim, Christopher Rao, Hutan Ashrafian, Umar Chaudhry, Ara Darzi, Thanos Athanasiou
- 2012
Aug 22, 2023 · It showed there is some evidence for specific reduction of MR with medical therapy. A small trial8 using triple heart failure therapy, but not SGLT2 inhibitors, showed that sMR was reduced by at least one grade in 40% of patients.
We found that postoperative SAM that recurred (after resolving intraoperatively) always resolved with medical therapy and did not require surgical intervention. We advocate an immediate intervention strategy for patients who have significant SAM intraoperatively that does not resolve with intraoperative medical therapy.
- Robin Varghese, Anelechi C. Anyanwu, Shinobu Itagaki, Federico Milla, Javier Castillo, David H. Adam...
- 2012
- Leaflet Motion: A Step-Wise Progression of Sam
- Hemodynamic Force: Lift vs. Drag Force
- Key Factors to Establish Sam
Figure 1 shows serial echocardiograms of the leaflet motions during SAM in patients suffering from SAM after mitral valve repair. At the early systolic phase, the mitral valve closes; coapting the opposing leaflets (Fig. 1.1, .2). Thereafter, the tip of the anterior leaflet moves anteriorly toward the ventricular septum (Fig. 1.3), and the residual...
As seen in the serial echocardiograms in Fig. 2, SAM begins with the displacement of the anterior leaflet tip into LVOT (or prepositioning), indicating that any force should operate on the leaflet. This force was initially considered lift force due to high-flow velocity in LVOT . This phenomenon is known as the “Venturi effect,” wherein the negativ...
Considering the diversity in the clinical setting that predispose SAM, the effort in trying to abstract the key factors for the establishment of SAM can significantly help in its comprehensive recognition. A wide variety of studies have elucidated possible key factors as essential requirements to establish SAM. Among them, three factors could be po...
- Susumu Manabe, Hitoshi Kasegawa, Hirokuni Arai, Shuichiro Takanashi
- 2018
Systolic anterior motion (SAM) is a postoperative complication experienced by patients undergoing mitral valve repair. The incidence of SAM after mitral valve repair ranges from 5 to 10%. Early recognition of the signs and symptoms of SAM is imperative to the management of these patients.
Nov 20, 2020 · Following SRT, efficacy of therapy, particularly evidence of septal thinning and LVOT gradient decrease, should be assessed. Residual SAM of the mitral valve and MR, aortic insufficiency, LV systolic and diastolic function, and ventricular septal defect should also be assessed.
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Is surgical treatment sufficient for MV repair Sam?
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Mar 25, 2024 · Treatment of mitral regurgitation (MR) depends upon the cause of the MR and the presence and severity of symptoms. Many people with mild or moderate MR do not require any specific treatment but should be monitored. (See 'Monitoring over time' above.) For people who do need treatment, options may include: Surgery to repair or replace the mitral ...
