A 61-year-old patient with the diagnosis of acute heart failure based on severe mitral valve insufficiency due to chordae rupture was scheduled for surgery. Intraoperatively, a standard two-dimensional transesophageal echocardiogram (2D-TEE) examination, revealed severe mitral valve regurgitation due to a prolaps with chordal rupture and an echo dense structure in the pulmonary artery (PA). Because it was not possible to visualize this echo dense structure fully with 2D-TEE we performed a three-dimensional transesophageal echocardiogram (3D-TEE). On the basis of the clear demonstration on 3D-TEE of an at least 6-cm thrombus in the PA we decided to remove the thrombus prior to proceeding with the mitral valve repair. We conclude that 3D-TEE can alter surgical management and provide more valuable information on PA thrombus than that obtained by 2D-TEE.

doi.org/10.1510/icvts.2010.257188, hdl.handle.net/1765/34511
Interactive Cardiovascular and Thoracic Surgery
Erasmus MC: University Medical Center Rotterdam

Scohy, T., Lüthen, C., Vletter-McGhie, J., & Oei, F. (2011). Three-dimensional transesophageal echocardiography: Diagnosing intraoperative pulmonary artery thrombus. Interactive Cardiovascular and Thoracic Surgery, 12(5). doi:10.1510/icvts.2010.257188