Systolic anterior motion of mitral valve after valve surgery
Systolic anterior motion (SAM) of anterior mitral leaflet (AML) is a classical finding in hypertrophic obstructive cardiomyopathy and it is a factor causing the obstruction as well as associated mitral regurgitation. But systolic anterior motion of the anterior mitral leaflet can also occur without hypertrophic cardiomyopathy, after repair of mitral valve. If the leaflet is very redundant, there can be SAM when the left ventricular size decreases after valve repair and if the ventricle is hyperdynamic. This is more likely when the distance between the valve coaptation point and the interventricular septum. Undersized annuloplasty ring also contributes to the development of post mitral valve repair SAM.