Surgical repair for systolic anterior motion of anterior mitral leaflet due to mitral annular calcification.

Systolic anterior motion of the anterior mitral leaflet with anterior displacement of the coaptation site of the bi-leaflets due to mitral annular calcification on the posterior side, causing left ventricular outflow tract obstruction, is rare. We report the case of a 72-year-old woman with exertional dyspnea due to systolic anterior motion who underwent surgical repair to decalcify the mitral annular calcification and mitral valve repair. Hence, the systolic anterior motion, mitral valve regurgitation, and symptoms improved significantly. This report illustrates the novelty of surgical technique, the indication, and the limitation of mitral valve repair for such rare cases. A proper understanding of the mechanism in each patient and enhanced techniques for decalcification of posterior mitral annular calcification are needed to treat such complex cases.