Recurrent ischaemic mitral regurgitation post mitral annuloplasty due to suture dehiscence evaluated using real time three dimensional transoesophageal echocardiography.
Ischaemic mitral regurgitation after myocardial infarction results from geometric changes in left ventricular shape and displacement of papillary muscles with resultant tethering and incomplete leaflet coaptation of mitral leaflets. Post mitral valve repair, both valve apparatus related factors such as persistent leaflet tethering and progressive left ventricular adverse remodelling and procedure related factors such as ring dehiscence are important causes of recurrent mitral regurgitation after initial undersized mitral ring annuloplasty. Three-dimensional echocardiography is a novel clinical tool that has the potential to provide additional anatomical and functional information regarding the mechanism of recurrent mitral regurgitation post mitral valve repair that is complementary to standard two dimensional transoesophageal echocardiography thus helping guide the most appropriate subsequent therapeutic intervention.
Department of Cardiology, Eastern Heart Clinic, Prince of Wales Hospital, Sydney, Australia. gunjhun@hotmail.com
Gunjan
G
Aggarwal
Dominik
D
Schlosshan
Gita
G
Mathur
Hugh
H
Wolfenden
Greg
G
Cranney
D058385:Cardiac Valve Annuloplasty / Q000009:adverse effects*; D017548:Echocardiography, Transesophageal; D006801:Humans; D021621:Imaging, Three-Dimensional; D007511:Ischemia / Q000209:etiology; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging* / Q000209:etiology; D012008:Recurrence; D013537:Sutures / Q000009:adverse effects*