Lyme Disease—An Unusual Cause of a Mitral Valve Endocarditis

Figures

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  Figure 1. A, Intraoperative prebypass TEE at initial mitral valve repair. The arrow on the left panel points to a large perforation in the anterior leaflet of the mitral valve. The right panel shows mitral regurgitation through mitral valve perforation. B, Postbypass TEE after initial mitral valve repair. The arrow on the left panel points to the autologous patch repair of the anterior leaflet of the mitral valve. There was no residual mitral regurgitation as seen in the right panel. TEE = transesophageal echocardiography.

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  Figure 2. The “Two-tier Testing Decision Tree” describes the steps required to properly test for Lyme disease by the Centers for Disease Control and Prevention.

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  Figure 3. A, Intraoperative prebypass transesophageal echocardiography at redo mitral valve repair. The arrow on the left panel points to a large perforation in the anterior leaflet of the mitral valve. The right panel shows mitral regurgitation through mitral valve perforation. B, Postbypass transesophageal echocardiography after redo mitral valve repair. The arrow on the left panel points to re-repair after resuturing a patch to the anterior leaflet of the mitral valve. There was only trivial residual mitral regurgitation as seen in the right panel.