Table 1.
Overview of events, treatment, NYHA class, and echocardiographic follow-up
| Event | Month & year | Treatment | Recipient NYHA class | TTE/TEE | Echocardiographic findings |
|---|---|---|---|---|---|
| Heart transplant |
June 2006 |
− |
4 |
Pre-op donor TTE |
MR 1+, TR 0, moderate LVF |
| Discharge |
June 2006 |
− |
3 |
Pre-discharge TTE |
MR 2+, TR1+, moderate LVF (inferoposterior hypokinesia) |
| NSTEMI (inferoposterior) |
June 2007 |
PCI RCA with 2 PRO-kinetic stents |
3 |
− |
− |
| Follow-up |
January 2008 |
− |
4 |
TTE and TEE |
MR 4+ (Figure
1A), TR 2+, dilatation of the LV and deterioration of LVF |
| MR severity: jet surface area (18.5 cm2)/ LA surface area (36.5 cm2) = 51%; vena contracta = 65 mm | |||||
| Mitral geometry: annular diameter = 39 mm (TEE, LAX), 40 mm (TTE, PLAX), 43 mm (TTE, AP4CH); intercommissural width = 36 mm (TEE, basal SAX); interpapillary muscle distance = 12 mm (TTE, PSAX); tenting height = 5 mm (TTE, AP4CH), 6 mm (TTE, PLAX); tenting area = 1.0 cm2 (TEE, LAX), 1.1 cm2 (TTE, AP4CH); posterior tethering angle = 20° (TTE, AP4CH); anterior tethering angle = 16° (TTE, PLAX) | |||||
| NSTEMI (inferior) |
May 2008 |
Mitral valve repair (CE classic 32 mm ring); hybrid PCI of the Cx |
2 |
Post-op TTE |
MR 1+, TR 1+, moderate LVF |
| Total AV block |
May 2008 |
DDD-pacemaker |
2 |
− |
− |
| Follow-up |
June 2008 |
− |
3 |
TTE and TEE |
MR 4+ (ring dehiscence) (Figure
1B), TR 4+ (Figure
1C), moderate LVF |
| |
July 2008 |
Redo mitral repair (ring refixation) and tricuspid repair (CE classic 36 mm ring) |
2 |
Post-op TTE |
MR 1+, TR 1+, moderate LVF |
| |
August 2008 |
− |
2 |
TTE |
Moderate LVF, intraventricular dyssynchronia |
| |
September 2008 |
Upgrade to CRT-D |
2 |
− |
− |
| |
July 2010 |
− |
2 |
TEE |
MR 1+ (Figure
1D), TR 1+ (Figure
1D), moderate LVF |
| February 2012 | − | 2 | TTE | MR 1+, TR 1+, moderate LVF |
AP4CH, apical four-chamber view; AV, atrioventricular; CE, Carpentier-Edwards; CRT-D, cardiac resynchronization therapy-defibrillator; Cx, circumflex coronary artery; DDD, dual chamber/dual demand; LA, left atrial; LV(F), left ventricular (function); MR, mitral regurgitation; NSTEMI, non-ST-segment elevation myocardial infarction; NYHA, New-York Heart Association; PCI, percutaneous coronary intervention; (P)LAX, (parasternal) long-axis view; (P)SAX, (parasternal) short-axis view; RCA, right coronary artery; TEE, transesophageal echocardiography; TR, tricuspid regurgitation; TTE, transthoracic echocardiography.