Catastrophic antiphospholipid syndrome in the setting of mitral valve repair

Figures

• 

  A and B, Mitral valve leaflet vegetations. C, Spectral and color Doppler TEE imaging.

• 

  Video 1. Simultaneous 2-dimensional and color Doppler imaging demonstrates bulky vegetation on both anterior and posterior mitral leaflets, involving primarily leaflet tips, associated with significant mitral regurgitation. Simultaneous biplane 2-dimensional imaging demonstrates the vegetation involving A2, P2, and P3 mitral valve scallops, further illustrated by 3-dimensional transesophageal echocardiography enface mitral valve imaging. Video available at: https://www.jtcvs.org/article/S2666-2507(21)00660-X/fulltext.

• 

  Figure 1. A, Mitral valve in systole, with red arrow indicating anterior mitral leaflet vegetation and white arrow indicating posterior leaflet vegetation. B, Mitral valve in diastole, with red arrow indicating anterior mitral leaflet vegetation and white arrow indicating posterior leaflet vegetation. C, Color and spectral Doppler transesophageal echocardiography imaging. Upper panel demonstrates significant color Doppler mitral regurgitation jet at area of vegetation. Lower left panel demonstrates mildly elevated inflow mitral gradient secondary to vegetation and increased transvalvular flow due to degree of mitral regurgitation. Lower right panel demonstrates end-systolic flow reversal in the pulmonary vein due to significant mitral regurgitation.