Conservative Management of Suicide Left Ventricle After Surgical Aortic Valve Replacement. 2023

Hamza Chraibi, and Lamyaa Bakamel, and Rokya Fellat, and Nesma Bendagha, and Said Moughil
Cardiology A Department, Ibn Sina Hospital, Mohammed V University, Rabat, MAR.

Suicide left ventricle (SLV) remains an underdiagnosed cause of haemodynamic compromise following surgical or transcatheter aortic valve replacement (AVR). Risk factors include female sex and a small left ventricular cavity with asymmetric septal hypertrophy. We present the case of a 63-year-old woman, with a medical history of diabetes mellitus, arterial hypertension and dyslipidaemia who was diagnosed with severe aortic stenosis with normal left ventricular ejection fraction and concentric hypertrophy. She underwent surgical AVR using a bioprosthetic valve, but a few hours after surgery, she developed sudden cardiogenic shock. An urgent transthoracic echocardiogram was performed showing marked systolic anterior motion of the mitral valve resulting in severe dynamic left ventricular outflow tract obstruction and intraventricular gradient. The diagnosis of SLV was made. The patient was managed conservatively with volume loading and oral beta-blockers and her haemodynamic state improved gradually. She was then discharged after favourable evolution. Medical management of SLV includes volume loading to expand the ventricular volume and beta-blockers for their negative inotrope effect. When medical therapy fails, surgical myectomy or alcohol septal ablation can be proposed to remove the obstacle. Some authors have proposed these procedures as prophylactic measures to prevent SLV in high-risk patients.

UI MeSH Term Description Entries

Related Publications

Hamza Chraibi, and Lamyaa Bakamel, and Rokya Fellat, and Nesma Bendagha, and Said Moughil
November 2023, JACC. Case reports,
Hamza Chraibi, and Lamyaa Bakamel, and Rokya Fellat, and Nesma Bendagha, and Said Moughil
July 2022, The Annals of thoracic surgery,
Hamza Chraibi, and Lamyaa Bakamel, and Rokya Fellat, and Nesma Bendagha, and Said Moughil
October 2010, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions,
Hamza Chraibi, and Lamyaa Bakamel, and Rokya Fellat, and Nesma Bendagha, and Said Moughil
April 2021, Journal of the American Heart Association,
Hamza Chraibi, and Lamyaa Bakamel, and Rokya Fellat, and Nesma Bendagha, and Said Moughil
May 2004, The Journal of heart valve disease,
Hamza Chraibi, and Lamyaa Bakamel, and Rokya Fellat, and Nesma Bendagha, and Said Moughil
January 2017, Methodist DeBakey cardiovascular journal,
Hamza Chraibi, and Lamyaa Bakamel, and Rokya Fellat, and Nesma Bendagha, and Said Moughil
January 2022, Journal of cardiothoracic surgery,
Hamza Chraibi, and Lamyaa Bakamel, and Rokya Fellat, and Nesma Bendagha, and Said Moughil
December 2006, Asian cardiovascular & thoracic annals,
Hamza Chraibi, and Lamyaa Bakamel, and Rokya Fellat, and Nesma Bendagha, and Said Moughil
April 2023, JACC. Cardiovascular interventions,
Hamza Chraibi, and Lamyaa Bakamel, and Rokya Fellat, and Nesma Bendagha, and Said Moughil
October 2013, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions,
Copied contents to your clipboard!