Philip Y.K. Pang, MD, Susan Garwood, MBChB, Sabet W. Hashim, MD

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Presentation transcript:

Intraoperative Bioprosthetic Valve Dysfunction Causing Severe Mitral Regurgitation Philip Y.K. Pang, MD, Susan Garwood, MBChB, Sabet W. Hashim, MD The Annals of Thoracic Surgery Volume 103, Issue 4, Pages e317-e319 (April 2017) DOI: 10.1016/j.athoracsur.2016.09.019 Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Intraoperative transesophageal echocardiography (TEE). (A) Restricted bioprosthetic valve leaflet (arrow). (B) Color Doppler image showing severe transvalvular mitral regurgitation (MR). The Annals of Thoracic Surgery 2017 103, e317-e319DOI: (10.1016/j.athoracsur.2016.09.019) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Explanted bioprosthetic mitral valve (MV). (A) Ventricular surface. A prominent crease and marked retraction was noted on L2. A less prominent crease was noted on L1. (B) Atrial surface. Creases were noted on 2 leaflets, which were more prominent on L2 than on L1. No typical suture looping mark was evident. Leaflets were discolored from dehydration during transfer to manufacturer for evaluation. (L1, L2, L3 = leaflets 1, 2, and 3, respectively; C1, C2, C3 = commissures 1, 2, and 3, respectively.) The Annals of Thoracic Surgery 2017 103, e317-e319DOI: (10.1016/j.athoracsur.2016.09.019) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 (A) Intraoperative transesophageal echocardiography (TEE) showing a restricted bioprosthetic valve leaflet (white arrow). Color Doppler image showing an eccentric transvalvular regurgitant jet (yellow arrow). (B) Explanted bioprosthesis showing folding and retraction of 1 leaflet (arrow). There was no evidence of suture looping. The Annals of Thoracic Surgery 2017 103, e317-e319DOI: (10.1016/j.athoracsur.2016.09.019) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions