Author + information
- Received December 14, 2009
- Accepted December 23, 2009
- Published online April 27, 2010.
- Juan José González-Ferrer, MD,
- Rodrigo Fernández-Jiménez, MD,
- Leopoldo Pérez de Isla, MD, PhD,
- Álvaro González Rocafort, MD and
- José Luis Zamorano, MD, PhD
A 40-year-old man was brought to our hospital because of resuscitated cardiac arrest. On the transthoracic echocardiography (TTE) an almost-complete dehiscence of a mechanical aortic valve that caused massive acute aortic regurgitation was noted (A and B). Moreover, vegetations around the aortic annulus and on the Valsalva sinus wall and an aortic roof abscess were also found. In addition to the routine echocardiography assessment, a 3-dimensional transesophageal echocardiography (TEE) was performed for a more exhaustive evaluation (C and D, Online Videos 1and 2). In spite of this catastrophic setting, urgent surgery was performed. Although the patient survived the surgery, he finally died within the following 24 h. The blood culture later proved the microbial cause: Streptococcus sanguis(E and F). In this case, both TTE and 2-dimensional TEE were enough to establish the diagnosis, but 3-dimensional TEE was useful to plan the surgery due to its ability to display spatial relationship between different cardiac structures in a faster and more intuitive way than TTE or 2-dimensional TEE.
- Received December 14, 2009.
- Accepted December 23, 2009.
- American College of Cardiology Foundation