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. 2008 Oct 6;1(1):216.
doi: 10.1186/1757-1626-1-216.

Paravalvular mitral valve leakage presenting as congestive heart failure, missed by TTE but diagnosed by TEE: a case report

Suriya Jayawardena  1 , Danushan Sooriabalan, Olga Burzyantseva, Selvaratnam Sinnapunayagm
Affiliations

Paravalvular mitral valve leakage presenting as congestive heart failure, missed by TTE but diagnosed by TEE: a case report

Suriya Jayawardena et al. Cases J. .

Abstract

Background: Diagnosis of prosthetic valve leakage by the transthoracic echocardiogram (TTE) technique is more difficult. These limitations are diminished with the use of transesophageal echocardiogram (TEE) techniques.

Case report: A 71 year old Caucasian male presented with symptoms and signs of congestive heart failure. Past medical history included a bio-prosthetic mitral valve replacement for severe mitral regurgitation. TTE showed possible mitral regurgitation. As the TTE did not correlate with the finding of a high E-velocity, a TEE was performed, which showed a significant paravalvular leak of moderate severity around the bio-prosthetic mitral valve.

Conclusion: There should be a high degree of suspicion to diagnose a paravalvular leak.

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Figures

Figure 1
Figure 1
Transthoracic Echocardiogram showing (arrow) possible mitral valve regurgitation.
Figure 2
Figure 2
Transesophageal Echocardiogram showing (arrow) a paravalvular mitral valve leak missed by the transthoracic echocardiogram.
See this image and copyright information in PMC

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