Ashikhmina E, Schaff HV, Daly RC, et al. - Researchers aimed at determining the predictors of systolic anterior motion (SAM) following mitral repair in a large cohort of consecutive patients. Further, they investigated the rate of early re-intervention on the mitral valve (MV) to address SAM and followed the progression of SAM postdismissal. Electronically stored echocardiographic exams of adults who underwent MV repair in a recent decade were analyzed. They identified SAM incidence of 13% immediately after the cardiopulmonary bypass (98 of 761 patients) following MV repair. The following transesophageal echocardiography findings were correlated with SAM: excessive height of posterior to anterior mitral leaflet, smaller left ventricular end-systolic volume and bileaflet prolapse. Usually, successful management was achieved with conservative management of SAM, and there was an uncommon occurrence of persistent hemodynamically significant SAM. It appears that prophylactic modification of the surgical technique to avoid SAM is irrelevant for all but those at the highest risk for developing SAM.