Systolic anterior motion of mitral valve after the posterior leaflet sliding advancement procedure.

The posterior leaflet sliding advancement procedure was developed to prevent the occurrence of systolic anterior motion of mitral valve and consequently outflow obstruction after mitral annuloplasty. We present a patient with extremely redundant posterior mitral leaflet in whom outflow obstruction developed despite employment of this procedure. This case underscores the utility of preoperative and intraoperative echocardiography in surgical decision making. Systolic anterior motion can develop in some patients despite this new surgical technique.