title: Diastolic Mitral Regurgitation in a Patient With Complex Native Mitral and Aortic Valve Endocarditis: A Rare Phenomenon With Potential Catastrophic Consequences.
abstract: Diastolic mitral valve regurgitation is a rare phenomenon described in patients with atrioventricular conduction abnormalities, severe left ventricular systolic or diastolic dysfunction with regional wall motion dyssynchrony, or severe acute aortic valve regurgitation. The presence of diastolic mitral valve regurgitation in acute aortic regurgitation due to endocarditis suggests critical severity requiring urgent surgical valve replacement. We describe a case of diastolic mitral regurgitation in the setting of complex native mitral-aortic valve endocarditis in a patient in normal sinus rhythm and review the etiologic mechanisms of this phenomenon, echocardiographic assessment, and therapeutic implications for hemodynamic management.
authors: Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA pulido.juan@mayo.edu.
authors: Juan N
authors: JN
authors: Pulido
authors: Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA.
authors: James J
authors: JJ
authors: Lynch
authors: Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA.
authors: William J
authors: WJ
authors: Mauermann
authors: Department of Medicine, Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
authors: Hector I
authors: HI
authors: Michelena
authors: Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA.
authors: Kent H
authors: KH
authors: Rehfeldt
mesh_terms: D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000000981:diagnostic imaging; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000601:surgery; D008944:Mitral Valve Insufficiency / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color
keywords: intraoperative assessment; intraoperative transesophageal echocardiography; mitral valve; monitoring; transesophageal echocardiography