title: Transesophageal Echocardiographic Diagnosis and Management of Circumflex Artery Injury Following Mitral Valve Repair.
abstract: A 16-year-old woman with severe mitral regurgitation as a result of rheumatic heart disease underwent mitral valve repair with posterior mitral annuloplasty. ST elevation was observed in leads II, III and aVF after weaning from cardiopulmonary bypass. On transesophageal echocardiography, the stenosis of the circumflex artery was suggested by a modified midesophageal long axis. Since the patient was hemodynamically unstable, an emergency coronary angiography could not be considered. An urgent cardiopulmonary bypass was re-instituted; the first two sutures in the P1 region of the posterior mitral annulus were translocated more superficially. Transesophageal echocardiography revealed good opening of the circumflex artery and improvement in regional wall motion abnormality following the corrected procedure.
authors.affiliation: Department of Anesthesiology and Cardiac Surgery, Narayana Hrudayalaya Hospitals, No. 258/A, Bommasandra industrial area, Anekal Taluk, Bangalore-560099, India.
authors.forename: Chinnamuthu
authors.initials: C
authors.lastname: Murugesan
authors.affiliation: Department of Anesthesiology and Cardiac Surgery, Narayana Hrudayalaya Hospitals, No. 258/A, Bommasandra industrial area, Anekal Taluk, Bangalore-560099, India.
authors.forename: Bheemaiah
authors.initials: B
authors.lastname: Raghu
authors.affiliation: Department of Anesthesiology and Cardiac Surgery, Narayana Hrudayalaya Hospitals, No. 258/A, Bommasandra industrial area, Anekal Taluk, Bangalore-560099, India.
authors.forename: Parachuri Venkateshwara
authors.initials: PV
authors.lastname: Rao
keywords: Mitral regurgitation; Mitral valve repair; Transesophageal echocardiography