about 35 y old patient with condition after mitral-valve reconstruction (Carpentier-ring 36 mm) because of severe high-grad symptomatic mitral-valve insufficiency caused by mitral-valve prolapse and
implantation of mechanical aortic prosthesis because of bicuspid aortic valve (SJM double tilting disk-prosthesis 25 mm). You can see a small prolapse of posterior mitral valve but no relevant m itral
valve insufficiency, no elevated transprothetic gradient (PGmean 2,7 mmHg). I used tissue-imagening to demonstrate mitral-valve movement.
about 70 y old patient with fever, breathlessness and a new haert murmur was admitted to our hospital. The clinical history showed a condition after aortic valve reconstruction years ago.
Now you can see a typical endocarditic vegetation of aortic valve. In my opinion that case is very interesting because despite the small vegetation is there a distinct effect of haemodynamic caused by
about 70 y old patient with condition after mitral valve reconstruction and implantation of capentier-ring (30 mm). Actually the patient was admitted to our hospital with prolonged dyspnoea. in TTE I
found a giant atrium caused by a distinct mitral walve insufficiency (radius aof PISA about 1,1 cm, regurgitationflow Q about 450 ml/s, vena contracta about 0,8-0,9 cm, regurgitation in pulmonary
veins) and a mild to severe mitral valve stenosis (PGmean about 15-18 mmHg!!!!).
about 75 y old patient with condition after implantation of prosthesis in aortic position about 10 month ago. Actually the patient has no clinical afflictions, in TTE I saw a distinct increase of
transprosthetic gradient (PGmean about 35-40 mmHg, LV-EF about 55%) and an large regurgitation jet (PHT 380 msec). In TEE so we could demonstrate an obstruction of the posterior disk, that explains
the incrase of transprothetic gradient and distinct regurgitation jet. You can see in the 3D-reconstruction, that the post disk doesn´t move. This finding was confirmed by continious x-ray, where we
could see no movement of one disk.
retrospectively, the reason for abstruction pf prothesis was an inappropriate anticoagulation with warfarine.
about 70 y old patient with prolonged dyspnea and interstitial oedema of lung. A condition of mitral valve replacement (Hancock biological mitral valve prosthesis) is known. In TTE (not shown) I saw a
distinct regurgitation beside the mitral valve prosthesis. So in TEE I could demonstrate a distinct paraprosthetic leckage with regurgitation in left upper pulmonary vein. 3D-reconstruction could
localised the paraprosthetic leckage between mitral valve prosthesis and LAA.
about 50 y old man with distinct dyspnoea in context of lung oedema. In TTE and TEE we found a severe mitral valve insufficiency with regurgitation in pulmonary veins caused by mitral valve prolapse
in context of rupture of chorda tendinea. The reason of the ruptur of chorda tendinea is not clear: no myocardial ischemia (no elevated troponin, no coronary occlusion in cardiac catheter) and no sign
of endocarditis (no elevated values of inflammation). Some idea?
After recompensation the patient was admitted to cardiac surgery for mitral valve reconstruction.