Mitral Annuloplasty Ring Dehiscence Diagnosed by Three-Dimensional Echocardiography

Abstract

1/3 https://jkms.orgAn unidentified male successfully resuscitated from cardiac arrest was admitted to our clinic for post-resuscitation care.Due to his unidentified status, we could not access any previous medical records.Chest radiography showed marked cardiomegaly with pulmonary congestion (Fig. 1).Thoracotomy scar was present on the right anterior chest wall.Transthoracic echocardiography revealed hyperechoic linear shaped mass originated from posterior mitral annulus on the left atrial side (Fig. 2A andB, Video 1).Severe mitral regurgitation was present.Although there was no definite evidence of cardiac surgery such as midline sternotomy wires or mediastinal surgical clips (Fig. 1), echocardiographic findings were suggestive of mitral annuloplasty ring dehiscence (Fig. 2A andB, Supplementary Video 1).The real time three-dimensional transesophageal echocardiography (3D TEE) confirmed the mitral annuloplasty ring dehiscence from the atrial perspective (Fig. 3, Supplementary Video 2).He was eventually identified and found to have undergone a robotically assisted minimally invasive mitral annuloplasty.