In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.
Did you know that your browser is out of date? To get the best experience using our website we recommend that you upgrade to a newer version. Learn more.

We use cookies to optimise the design of this website and make continuous improvement. By continuing your visit, you consent to the use of cookies. Learn more

Prosthetic mitral valve dysfunction with intermittent regurgitation

Authors:  Dr. Julia Grapsa, Dr. Michael F Bellamy, Dr. Andreas Kalogeropoulos, Dr. Grigorios Karamasis,
Mr. David Dawson, Prof. Petros Nihoyannopoulos.

Hammersmith Hospital
Imperial College NHS Trust

Contact : Julia Grapsa,
EACVI ambassador for Greece

On behalf of the EACVI club 35 for Greece


 

Description

  • 62 years old female
  • Admitted with shortness of breath, signs of orthopnoea and left sided heart failure.
  • She underwent mitral valve replacement (bileaflet St Jude valve) 2 months ago.
  • She underwent transesophagel echocardiogram for careful prosthetic valve evaluation.

Clinical case information

http://www.youtube.com/watch?v=OwNwW_a-0r8
http://www.youtube.com/watch?v=Pf2EFjGzAB8
2D TEE: 4 chamber at 0 degrees view. The imaging plane is directed through the left atrium and centered in the prosthetic mitral valve. There is prosthetic regurgitation Real time 3D TEE of the mitral prosthesis. One of the two disks is slightly blocked by a very fast moving mass and has some delay in movement causing regurgitation.

 

http://www.youtube.com/watch?v=eG_fKpSKLh8
http://www.youtube.com/watch?v=BI1Q8y7FmFs
3D TEE left ventricular view of the mitral prosthesis
One of the two leaflets of the bicuspid St Jude mitral valve has a delay in movement, that causes valve regurgitation demonstrated with colour Doppler. Severe intermittent regurgitation through the partially blocked disk is seen in colour Doppler 3D TOE.

Conclusion

TOE demonstrated dysfunction of one of the leaflets of the prosthetic valve and intermittent regurgitation. Patient was referred for a new replacement of the mitral valve. She had an uneventful postoperative period and discharged to home.