Journal of Perioperative Echocardiography

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VOLUME 2 , ISSUE 1 ( January-June, 2014 ) > List of Articles

RESEARCH ARTICLE

Selected Abstracts of the TEEPGI 2014 Workshop

Citation Information : Selected Abstracts of the TEEPGI 2014 Workshop. J Perioper Echocardiogr 2014; 2 (1):42-48.

DOI: 10.5005/jope-2-1-42

License: CC BY-SA 4.0

Published Online: 01-06-2014

Copyright Statement:  Copyright © 2014; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Mitral valve perforation is most commonly due to infective endocarditis. Iatrogenic mitral valve perforation following aortic valve replacement has not been described previously. A 57 years male patient presented with complaints of progressive dyspnea on exertion and occasional palpitations. A preoperative diagnosis of severe aortic stenosis, sclerodegenerative aortic valve with normal left ventricle function was made on transthoracic echocardiography. A coronary angiogram showed single vessel disease involving proximal left anterior descending artery causing 80% stenosis. The patient was planned for aortic valve replacement (AVR) and CABG. Pre bypass TEE showed bicuspid aortic valve, thick, calcified, severe aortic stenosis and normal left ventricle systolic function. Mitral valve was morphologically normal with mild central mitral regurgitation jet. Patient underwent CABG and AVR under cardiopulmonary bypass support.

Post CPB TEE examination showed 2 jets of mitral regurgitation in midesophageal aortic long-axis view (Fig. 1). There was a mild central MR jet and an additional mild MR jet from the body of anterior mitral leaflet. Transgastric short axis view showed turbulence in the region of A1 scallop of anterior mitral leaflet. We present the intraoperative TEE images of the patient with a discussion on the role of TEE in detection of mitral valve perforation and surgical decision making.


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  1. Sellers RD, Anderson RC, Adams P, Lillehei CW, Edwards JE. The developmental complex of ‘parachute mitral valve,’ supravalvular ring of left atrium, subaortic stenosis and coarctation of aorta.’ Am J of Cardiolo 1963;11:714-725.
  2. A forme frust of Shone's anomaly in a 65-year-old patient. McGill J Medi 2008;11(1):19-21.
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