{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,4,22]],"date-time":"2022-04-22T02:40:20Z","timestamp":1650595220406},"reference-count":7,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2015,12,1]],"date-time":"2015-12-01T00:00:00Z","timestamp":1448928000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2015,12,1]],"date-time":"2015-12-01T00:00:00Z","timestamp":1448928000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Echo Res Pract"],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>We present a case of mitral valve (MV) replacement that resulted in multiple complications, as diagnosed by transesophageal echocardiography (TEE), including left ventricular outflow tract obstruction, aortic dissection and left ventricular rupture. We also describe that identification of bleeding originating from the posterior aspect of the heart by the surgical team should trigger a complete TEE evaluation for adequate diagnosis. An 84-year-old woman underwent a MV replacement. Weaning from cardiopulmonary bypass (CPB) revealed a late-peaking gradient of 44 mmHg over the left ventricular outflow tract caused by obstruction from a bioprosthetic strut. After proper surgical correction, TEE evaluation showed a type A aortic dissection that was subsequently repaired. After separation from CPB, the surgical team identified a major bleed that originated from the posterior aspect of the heart. Although the initial suspicion was injury to the atrioventricular groove, a complete TEE evaluation confirmed a left ventricular free wall rupture by showing the dissecting jet using colour-flow Doppler. TEE is an essential component in cardiac surgery for assessment of surgical repair and potential complications. Posterior bleeding should trigger a complete TEE examination with assessment of nearby structures to rule out a life-threatening pathology. Left ventricular free wall rupture can be identified using colour-flow Doppler.<\/jats:p>","DOI":"10.1530\/erp-15-0026","type":"journal-article","created":{"date-parts":[[2015,11,27]],"date-time":"2015-11-27T02:58:23Z","timestamp":1448593103000},"page":"K37-K41","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Transesophageal echocardiographic imaging of multiple complications following mitral valve replacement"],"prefix":"10.1186","volume":"2","author":[{"given":"Charles L.","family":"Brassard","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Viens","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9","family":"Denault","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre","family":"Couture","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2015,12,1]]},"reference":[{"key":"204006_CR1","doi-asserted-by":"publisher","first-page":"825","DOI":"10.1016\/S1010-7940(02)00465-7","volume":"22","author":"GW Rietman","year":"2002","unstructured":"Rietman GW, van der Maaten JM, Douglas YL, & Boonstra PW 2002 Echocardiographic diagnosis of left ventricular outflow tract obstruction after mitral valve replacement with subvalvular preservation. European Journal of Cardio-Thoracic Surgery 22 825\u2013827. (doi:10.1016\/S1010-7940(02)00465-7)","journal-title":"European Journal of Cardio-Thoracic Surgery"},{"key":"204006_CR2","first-page":"399","volume":"33","author":"N Guler","year":"2006","unstructured":"Guler N, Ozkara C, & Akyol A 2006 Left ventricular outflow tract obstruction after bioprosthetic mitral valve replacement with posterior mitral leaflet preservation. Texas Heart Institute Journal 33 399\u2013401.","journal-title":"Texas Heart Institute Journal"},{"key":"204006_CR3","doi-asserted-by":"publisher","first-page":"735","DOI":"10.1016\/j.athoracsur.2005.10.006","volume":"82","author":"K Okamoto","year":"2006","unstructured":"Okamoto K, Kiso I, Inoue Y, Matayoshi H, Takahashi R, & Umezu Y 2006 Left ventricular outflow obstruction after mitral valve replacement preserving native anterior leaflet. Annals of Thoracic Surgery 82 735\u2013737. (doi:10.1016\/j.athoracsur.2005.10.006)","journal-title":"Annals of Thoracic Surgery"},{"key":"204006_CR4","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1016\/S0022-5223(19)38880-4","volume":"85","author":"DA Murphy","year":"1983","unstructured":"Murphy DA, Craver JM, Jones EL, Bone DK, Guyton RA, Hatcher CR, Jr 1983 Recognition and management of ascending aortic dissection complicating cardiac surgical operations. Journal of Thoracic and Cardiovascular Surgery 85 247\u2013256.","journal-title":"Journal of Thoracic and Cardiovascular Surgery"},{"key":"204006_CR5","doi-asserted-by":"publisher","first-page":"101","DOI":"10.4137\/CMC.S2533","volume":"3","author":"SI Sersar","year":"2009","unstructured":"Sersar SI, & Jamjoom AA 2009 Left ventricular rupture post mitral valve replacement. Clinical Medicine Cardiology 3 101\u2013113.","journal-title":"Clinical Medicine Cardiology"},{"key":"204006_CR6","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1016\/S0003-4975(98)00537-2","volume":"66","author":"NC Poirier","year":"1998","unstructured":"Poirier NC, Ugolini P, Pellerin M, Petitclerc R, & Tardif JC 1998 Transesophageal echocardiographic evaluation of perioperative coronary sinus trauma. Annals of Thoracic Surgery 66 573\u2013575. (doi:10.1016\/S0003-4975(98)00537-2)","journal-title":"Annals of Thoracic Surgery"},{"key":"204006_CR7","doi-asserted-by":"publisher","first-page":"1074","DOI":"10.1213\/ANE.0000000000000306","volume":"119","author":"J Chui","year":"2014","unstructured":"Chui J, Roscoe A, & Tsang W 2014 Atrioventricular disruption after mitral valve replacement: the role of intraoperative transesophageal echocardiography. Anesthesia and Analgesia 119 1074\u20131077. 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