title: Echocardiographic recognition of iatrogenic aortic valve leaflet perforation.
abstract: BACKGROUND
  There is a paucity of literature regarding iatrogenic aortic valve perforation after cardiac operations performed in the vicinity of the aortic valve. This report describes the echocardiographic recognition of iatrogenic aortic valve perforation.
  
  
  METHODS
  Among 6 patients who had previously under-gone non-aortic valve cardiac operations, a diagnosis of iatrogenic aortic regurgitation was made by transthoracic two-dimensional echocardiography and Doppler color flow imaging.
  
  
  RESULTS
  The location of the aortic valve leaflet perforation varied and depended on the site of the previous intracardiac lesion repair. Repeat operations in 5 patients confirmed the echocardiographic findings. Aortic valve repair was confirmed in 2 patients by transesophageal echocardiography, whereas aortic valve replacement became necessary in 2 other patients. A fifth patient with acquired cardiomyopathy underwent orthotopic heart transplantation.
  
  
  CONCLUSIONS
  A detailed two-dimensional echocardiographic examination, along with color flow imaging, should be done to evaluate iatrogenic aortic valve perforation in patients with a new murmur of aortic regurgitation after cardiac operations in proximity to the aortic valve. Precise preoperative diagnosis of this lesion allows optimal surgical planning and treatment.
authors.affiliation: Department of Surgery, Loma Linda University, California, USA.
authors.forename: A C
authors.initials: AC
authors.lastname: Hill
authors.forename: R C
authors.initials: RC
authors.lastname: Bansal
authors.forename: A J
authors.initials: AJ
authors.lastname: Razzouk
authors.forename: M
authors.initials: M
authors.lastname: Liu
authors.forename: L L
authors.initials: LL
authors.lastname: Bailey
authors.forename: S R
authors.initials: SR
authors.lastname: Gundry
mesh_terms: D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D009202:Cardiomyopathies / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D002648:Child; D004452:Echocardiography; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D006343:Heart Septal Defects / Q000601:surgery; D016027:Heart Transplantation; D006350:Heart Valve Prosthesis / Q000009:adverse effects; D006801:Humans; D007049:Iatrogenic Disease; D007223:Infant; D008297:Male; D008943:Mitral Valve / Q000601:surgery; D008944:Mitral Valve Insufficiency / Q000601:surgery; D010347:Patient Care Planning; D010496:Pericardium / Q000637:transplantation; D012086:Reoperation