Severe Intermittent Transvalvular Mitral Valve Regurgitation

Figure 1. Color Doppler View of Severe Mitral Regurgitation Multiplane transesophageal echocardiography with color Doppler imaging revealed severe transvalvular mitral regurgitation, which was intermittent. LA = left atrium; LV = left ventricle.

Figure 2. M-Mode and Vena Contracta Views of Severe Mitral Regurgitation Color M-mode transesophageal echocardiographic image showing intermittent pansystolic mitral regurgitation (A) and mitral regurgitation (vena contracta [VC] width 0.6 cm) measured by color Doppler imaging (B).

Figure 3. 2- and 3-Dimensional Images of Mass (A) Two-dimensional transesophageal echocardiographic image showing the 2 leaflets of the mechanical mitral valve prosthesis in the open position, with an abnormal mass measuring 14 mm × 7 mm (arrow) on the ventricular side of the prosthesis. (B) Real-time 3-dimensional transesophageal echocardiography demonstrating impingement of a mass (arrow) between the disc of the valve and the housing. AV = aortic valve; LAA = left atrial appendage.

Figure 4. Intraoperative View of the Subvalvular Apparatus Remnants Excision of posterior leaflet and chordae tendineae remnants, which were observed during surgery.

Figure 5. Post-Operative 2- and 3-Dimensional Images of Prosthetic Mitral Valve (A) Post-operative color Doppler transesophageal echocardiogram showing physiological transvalvular mitral regurgitation without an abnormal jet. (B, C) Two-dimensional transesophageal echocardiogram (B) and real-time 3-dimensional transesophageal echocardiogram (C) showing normal prosthetic valve motion without a mass.