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Year : 2019  |  Volume : 29  |  Issue : 2  |  Page : 78-81

The additional value of three-dimensional transesophageal echocardiography in the diagnosis of unusual complication of bioprosthetic mitral valve

1 Department of Cardiology, I.R.C.C.S. Policlinico San Donato, University of Milan, Milan, Italy
2 Department of Cardiology, I.R.C.C.S. Policlinico San Donato, San Donato Milanese, Milan, Italy
3 Department of Cardiology University, I.R.C.C.S. Policlinico San Donato, San Donato Milanese; Department of Biomedical Sciences for Health, I.R.C.C.S. Policlinico San Donato, University of Milan, Milan, Italy

Correspondence Address:
Martina Evangelista
Via Giacomo Leopardi 39/4, Arese (MI) 20020
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcecho.jcecho_75_18

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Primary tissue failure of bioprosthetic mitral valves due to cusp perforations or ruptures is an unusual complication on short-term follow-up. An 88-year-old male with a known history of mitral regurgitation (MR) treated with bioprosthetic valve replacement in 2016 was referred to our center for recurrent heart failure. The two-dimensional (2D) transthoracic echocardiography documented an intraprosthetic jet of regurgitation without identifying a clear morphological mechanism, nor quantifying precisely the mitral insufficiency. 3D transesophageal echocardiography (TOE) with the tool FlexiSlice added relevant information by providing insights into the pathophysiological mechanisms of MR. The present case emphasizes the importance of 3D TOE as a fundamental tool for the diagnostic algorithm of bioprosthetic valves failure, even in the more demanding cases.

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