Usefulness of intraoperative real-time three-dimensional transesophageal echocardiography for pre-procedural evaluation of mitral valve cleft: a case report.
10.4097/kjae.2014.66.1.75
- Author:
Hyun Ju JUNG
1
;
Ga Yon YU
;
Jung Ho SEOK
;
Chungsik OH
;
Seong Hyop KIM
;
Tae Gyoon YOON
;
Tae Yop KIM
Author Information
1. Department of Anesthesiology and Pain Medicine, Uijongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea.
- Publication Type:Case Report
- Keywords:
Mitral valve insufficiency;
Transesophageal echocardiography
- MeSH:
Adult;
Balloon Valvuloplasty;
Diagnosis;
Echocardiography;
Echocardiography, Transesophageal*;
Female;
Humans;
Lifting;
Mitral Valve Insufficiency;
Mitral Valve Stenosis;
Mitral Valve*;
Pathology;
Pregnancy;
Rupture
- From:Korean Journal of Anesthesiology
2014;66(1):75-79
- CountryRepublic of Korea
- Language:English
-
Abstract:
A precise pre-procedural evaluation of mitral valve (MV) pathology is essential for planning the surgical strategy for severe mitral regurgitation (MR) and preparing for the intraoperative procedure. In the present case, a 38-year-old woman was scheduled to undergo MV replacement due to severe MR. She had a history of undergoing percutaneous balloon valvuloplasty due to rheumatic mitral stenosis during a previous pregnancy. A preoperative transthoracic echocardiography suggested a tear in the mid tip of the anterior mitral leaflet. However, the "en face" view of the MV in the left atrial perspective using intraoperative real time three-dimensional transesophageal echocardiography (RT 3D-TEE) provided a different diagnosis: a torn cleft in the P2-scallop of the posterior mitral leaflet (PML) with rupture of the chordae. Thus, surgical planning was changed intraoperatively to MV repair (MVRep) consisting of patch closure of the PML, commissurotomy, and lifting annuloplasty. The present case shows that intraoperative RT 3D-TEE provides more precise and reliable spatial information of MV for MVRep and facilitates critical surgical decision-making.
