Anesthetic Management of Intra-aortic Balloon Pump-Induced Systolic Anterior Motion of the Mitral Valve During Coronary Artery Bypass Grafting.


East Florida


Westside Regional Medical Center

Document Type

Case Report

Publication Date



cardiothoracic anesthesia, coronary artery bypass graft (cabg), hypertrophic obstructive cardiomyopathy (hocm), intra-aortic balloon pump (iabp), left ventricular outflow tract obstruction (lvoto), perioperative tee, systolic anterior motion of mitral valve


Anesthesiology | Cardiovascular Diseases | Medicine and Health Sciences


The intra-aortic balloon pump (IABP) is a mechanical device that increases myocardial oxygen perfusion and indirectly increases cardiac output through afterload reduction. Since its inception, the IABP has been a mainstay of cardiac support devices, utilized as a temporizing measure in patients with or prone to developing cardiogenic shock that are awaiting definitive treatment. Systolic anterior motion (SAM) of the mitral valve is a well-described phenomenon that can precipitate hemodynamic collapse by obstructing the left ventricular outflow tract in a subset of patients with cardiac pathology, most notably hypertrophic obstructive cardiomyopathy (HOCM). This report describes the case and anesthetic management of a patient who had an IABP placed for support and later developed SAM and hemodynamic compromise after induction of general anesthesia during a coronary artery bypass surgery.

Publisher or Conference