Paravalvular mitral valve leakage presenting as congestive heart failure, missed by TTE but diagnosed by TEE: a case report.
BACKGROUND
Diagnosis of prosthetic valve leakage by the transthoracic echocardiogram (TTE) technique is more difficult. These limitations are diminished with the use of transesophageal echocardiogram (TEE) techniques.


METHODS
A 71 year old Caucasian male presented with symptoms and signs of congestive heart failure. Past medical history included a bio-prosthetic mitral valve replacement for severe mitral regurgitation. TTE showed possible mitral regurgitation. As the TTE did not correlate with the finding of a high E-velocity, a TEE was performed, which showed a significant paravalvular leak of moderate severity around the bio-prosthetic mitral valve.


CONCLUSIONS
There should be a high degree of suspicion to diagnose a paravalvular leak.
Coney Island Hospital, 2601 Ocean Park Way, Brooklyn, NY 11235, USA. suriyakbrsj@yahoo.com.
Suriya
S
Jayawardena
Danushan
D
Sooriabalan
Olga
O
Burzyantseva
Selvaratnam
S
Sinnapunayagm