title: Three-dimensional transesophageal echocardiography: diagnosing intraoperative pulmonary artery thrombus.
abstract: A 61-year-old patient with the diagnosis of acute heart failure based on severe mitral valve insufficiency due to chordae rupture was scheduled for surgery. Intraoperatively, a standard two-dimensional transesophageal echocardiogram (2D-TEE) examination, revealed severe mitral valve regurgitation due to a prolaps with chordal rupture and an echo dense structure in the pulmonary artery (PA). Because it was not possible to visualize this echo dense structure fully with 2D-TEE we performed a three-dimensional transesophageal echocardiogram (3D-TEE). On the basis of the clear demonstration on 3D-TEE of an at least 6-cm thrombus in the PA we decided to remove the thrombus prior to proceeding with the mitral valve repair. We conclude that 3D-TEE can alter surgical management and provide more valuable information on PA thrombus than that obtained by 2D-TEE.
authors.affiliation: Department of Anesthesiology, Erasmus Medical Center, Room Bd 581, Dr Molenwaterplein 40, 3015 CE Rotterdam, The Netherlands.
authors.forename: Thierry V
authors.initials: TV
authors.lastname: Scohy
authors.forename: Christian
authors.initials: C
authors.lastname: Lüthen
authors.forename: Jackie
authors.initials: J
authors.lastname: McGhie
authors.forename: Frans
authors.initials: F
authors.lastname: Oei
mesh_terms: D006348:Cardiac Surgical Procedures; D002815:Chordae Tendineae / Q000000981:diagnostic imaging; D019560:Echocardiography, Three-Dimensional; D017548:Echocardiography, Transesophageal; D006341:Heart Rupture / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007430:Intraoperative Care; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D011237:Predictive Value of Tests; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000601:surgery; D017131:Thrombectomy; D016896:Treatment Outcome