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Prosthetic mitral valve dysfunction with intermittent regurgitation

EACVI Valvular Imaging Box

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



  • 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


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.



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.


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