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Separation anxiety: Extreme dehiscence of a mitral annuloplasty ring
Authors:Mary Mashicharan  Ian Loke  Viktor Zlocha  Jeffrey Khoo
Abstract:We report a patient admitted with acute pulmonary edema 3 months after mitral valve repair, with no history of inter‐current febrile illness. Transesophageal echocardiography (TEE) demonstrated severe mitral regurgitation (MR) and an abnormally positioned annuloplasty ring, suggestive of dehiscence. The extreme extent of ring dehiscence was visualized on 3‐dimensional TEE (3D), with near‐complete separation of the ring. Strept.Mitis and Cristatus were isolated from the ring following redo mitral valve surgery, confirming endocarditis as the mechanism for dehiscence. This report highlights the additive role and superior ability of 3D TEE in the identification and anatomic delineation of mitral ring dehiscence.
Keywords:dehiscence  mitral annuloplasty  mitral valve repair  transesophageal echocardiography
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