We present herein several transesophageal echocardiogram (TEE) images of a 60-year-old man referred to the cardiac surgeon for a triple coronary artery bypass graft procedure, in which a normally-functioning double orifice mitral valve (DOMV) was an incidental finding during routine intraoperative TEE. This is a very rare congenital malformation, even rarer as an isolated anomaly in an elderly patient. Three-dimensional TEE (3D-TEE) confirmed the diagnosis and provided complete and fast assessment of the mitral valve and the surrounding structures and all the information needed to reassess the surgical strategy in the very short pre‑bypass period.
Figure 1.
Real-time 3D-transesophageal echocardiogram „en face" view from the left atrium („surgeon's view", Panel A) and from the LV (Panel B) revealing two asymmetrical orifices, a smaller lateral (1) and a bigger medial (2) mitral orifice, separated by fibrous tissue (arrow). Panel C- achieved after using a sagittal crosssectional plane to "split" the valve and the LV in two for better view of the orifices and unrestricted opening of the mitral valve. Panel D. 2D (left) and 3D-zoom mode (right) transgastric view of the two orifices. LV, left ventricle.
Acknowledgement
This paper is partly supported by the Sectorial Operational Programme of Human Resources Development (SOPHRD), financed by the European Social Fund and the Romanian Government under contract number POSDRU 141531.
Footnotes
Author contributions
Conception and design of the research:Ciobanu AO, Bennett S, Vinereanu D. Acquisition of data:Ciobanu AO, Bennett S. Analysis and interpretation of the data: Ciobanu AO, Bennett S, Lopes RD, Vinereanu D. Writing of the manuscript:Ciobanu AO. Critical revision of the manuscript for intellectual content: Ciobanu AO, Bennett S, Lopes RD, Vinereanu D. Supervision / as the major investigador: Vinereanu D.
Potential Conflict of Interest
No potential conflict of interest relevant to this article was reported.
Sources of Funding
There were no external funding sources for this study.
Study Association
This study is not associated with any thesis or dissertation work.