Echo rounds: application of real-time 3-dimensional transesophageal echocardiography in the percutaneous closure of a mitral paravalvular leak.

摘要

A 51-year-old m'an presented to our hospital with increasing shortness of breath and lower extremity edema. He was status post St. Jude mechanical mitral valve replacement for endocarditis 4 years before admission. Transesophageal echocardiography (TEE) revealed a severe paravalvular leak around the inferolateral aspect of the sewing ring. Left ventricular systolic function was reduced (ejection fraction of 35%-45%). His mean diastolic pressure gradient across the mitral valve was 6 mm Hg. A small secundum atrial septal defect (ASD) with bidirectional shunting was observed.