Journal of Perioperative Echocardiography

Register      Login

VOLUME 7 , ISSUE 1 ( January-June, 2019 ) > List of Articles

CASE REPORT

Indispensable Role of Transesophageal Echocardiography in Elucidating the Mechanism of Bioprosthetic Heart Valve Dysfunction Causing Severe Regurgitation: A Case Report

Srinath Damodaran, Rajarajan Ganesan, Indranil Biswas, Bhupesh Kumar

Keywords : Bioprosthetic heart valves, Flail leaflet, Transesophageal echocardiography

Citation Information : Damodaran S, Ganesan R, Biswas I, Kumar B. Indispensable Role of Transesophageal Echocardiography in Elucidating the Mechanism of Bioprosthetic Heart Valve Dysfunction Causing Severe Regurgitation: A Case Report. J Perioper Echocardiogr 2019; 7 (1):15-17.

DOI: 10.5005/jp-journals-10034-1098

License: CC BY-NC 4.0

Published Online: 01-06-2019

Copyright Statement:  Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Transesophageal echocardiography (TEE) is invaluable in identifying the exact mechanism of prosthetic valve dysfunction (PVD), which may help in the proper management of patient. Here, we report a case of severe mitral regurgitation due to flail mitral valve leaflet resulting from torn bioprosthetic cusp where TEE was instrumental in demonstrating the exact mechanism of valve dysfunction.


PDF Share
  1. Edmunds LH. Jr. Thromboembolic complications of current cardiac valvular prostheses. Ann Thorac Surg 1982;34(1):96–106. DOI: 10.1016/s0003-4975(10)60862-4.
  2. Russhard P, Weerasinghe A. Intermittent jamming of a bileaflet mechanical heart valve in the absence of any extrinsic cause of obstruction. Eur J Echocardiogr 2011;12(3):E19. DOI: 10.1093/ejechocard/jeq173.
  3. Ma WG, Hou B, Abdurusul A, et al. Dysfunction of mechanical heart valve prosthesis: experience with surgical management in 48 patients. J Thorac Dis 2015;7(12):2321–2329. DOI: 10.3978/j.issn.2072-1439.2015.12.25.
  4. Jamieson W, Munro A, Miyagishima R, et al. Carpentier-edwards standard porcine bioprosthesis: clinical performance to seventeen years. Ann Thorac Surg 1995;60(4):999–1006. DOI: 10.1016/0003-4975(95)00692-e.
  5. Butany J, Leask R. The failure modes of biological prosthetic heart valves. J Long Term Eff Med Implants 2001;11(3-4):115–136. DOI: 10.1615/JLongTermEffMedImplants.v11.i34.30.
  6. Habets J, Budde RP, Symersky P, et al. Diagnostic evaluation of left-sided prosthetic heart valve dysfunction. Nat Rev Cardiol 2011;8(8):466–478. DOI: 10.1038/nrcardio.2011.71.
  7. Schoen F, Fernandez J, Gonzalez-Lavin L, et al. Causes of failure and pathologic findings in surgically removed inoescu-shiley standard bovine pericardial heart valve bioprostheses: emphasis on progressive structural deterioration. Circulation 1987;76(3):618–627. DOI: 10.1161/01.cir.76.3.618.
  8. Ishihara T, Ferrans VJ, Boyce SW, et al. Structure and classification of cuspal tears and perforations in porcine bio-prosthetic cardiac valves implanted in patients. Am J Cardiol 1981;48(4):665. DOI: 10.1016/0002-9149(81)90145-4.
  9. Siddiqui RF, Abraham JR, Butany J. Bioprosthetic heart valves: modes of failure. Histopathology 2009;55(2):135–144. DOI: 10.1111/j.1365-2559.2008.03190.x.
  10. Barbetseas J, Nagueh SF, Pitsavos C, et al. Differentiating thrombus from pannus formation in obstructed mechanical prosthetic valves: an evaluation of clinical, transthoracic and transesophageal echocardiographic parameters. J Am Coll Cardiol 1998;32(5): 1410–1417. DOI: 10.1016/s0735-1097(98)00385-4.
  11. Lin SS, Tiong IY, Asher CR, et al. Prediction of thrombus-related mechanical prosthetic valve dysfunction using transesophageal echocardiography. Am J Cardiol 2000;86(10):1097–1101. DOI: 10.1016/s0002-9149(00)01166-8.
  12. Edmunds L, Clark R, Cohn L, et al. Guidelines for reporting morbidity and mortality after cardiac valvular operations. Ann Thorac Surg 1996;62(3):932–935. DOI: 10.1016/s0003-4975(96)00531-0.
  13. Rozich JD, Edwards WD, Hanna RD, et al. Mechanical prosthetic valve associated strands: pathologic correlates to transesophageal echocardiography. J Am Soc Echocardiogr 2003;16(1):97–100. DOI: 10.1067/mje.2003.36.
  14. Evangelista A, Gonzalez-Alujas MT. Echocardiography in infective endocarditis. Heart 2004;90(6):614–617. DOI: 10.1136/hrt.2003. 029868.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.