Transaortic correction of systolic anterior motion of the mitral leaflet after aortic and mitral valve replacement.

Left ventricular outflow tract obstruction is a rare and critical complication after mitral valve replacement. We report a patient who presented with severe left ventricular outflow tract obstruction caused by systolic anterior motion of the native mitral leaflet after aortic and mitral valve replacement. The patient was successfully treated by resection of the anterior mitral leaflet through the 19-mm bioprosthetic valve in the aortic position. This approach is quite simple and effective, even through the small aortic bioprosthesis, and does not require a second mitral valve replacement.