Stuck bioprosthetic mitral valve leaflet
by Nanda Navin C, Karakus Gültekin, Degirmencioglu Aleks

Manual of Echocardiography

by Navin C Nanda, Gültekin Karakuş, Aleks Değirmencioğlu
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This video clip shows intraoperative transesophageal echocardiography. A 75-year-old male underwent mitral valve replacement for severe mitral regurgitation secondary to calcification and myxoid valvular changes. In the post bypass period a portion of the papillary muscle with an attached chord (arrow) trapped within the prosthetic leaflets (#1 and #2) is seen. In diastole, leaflet #1 opens well but leaflet #2 remains stuck in the closed position. Color Doppler examination shows significant mitral regurgitation (MR). After resection of the obstructing chord and papillary muscle both leaflets showed normal motion with trivial mitral regurgitation. Asterisks represent the struts of bioprosthetic valve. (LA: Left atrium; LV: Left ventricle). Source: Reproduced with permission from: Singh A, Nanda NC and Kirklin J. Intraoperative Transesophageal Echocardiographic Diagnosis of a Stuck Bioprosthetic Mitral Valve Leaflet. Echocardiography 2007;24(4):436-438

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