CTICasesLeft Ventricular Outflow Tract Obstruction by Mitral Valve Bioprosthesis
Imaging findings
Cardiac CT and three-chamber cinematic reconstructions demonstrate a surgically placed bioprosthetic mitral valve. A prominent valve strut is seen extending into and dynamically obstructing the left ventricular outflow tract (LVOT) during systole. Additionally, there is systolic anterior motion (SAM) of the adjacent chordae tendineae, which are dynamically drawn into the narrowed LVOT due to the Venturi effect.
Key takeaways
Dynamic left ventricular outflow tract (LVOT) obstruction is a potential complication of mitral valve replacement or repair. It can occur when bioprosthetic valve struts or retained native mitral valve tissue project anteriorly into the outflow tract, generating a Venturi effect that dynamically sucks the chordae or leaflet tissue into the LVOT during systole, leading to functional aortic stenosis.
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