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- W2010383816 abstract "AN 81-YEAR-OLD, 65-kg, 164-cm man was admitted to the authors' institution for the evaluation of progressive dyspnea and fatigue. The patient denied chest pain, orthopnea, paroxysmal nocturnal dyspnea, palpitations, and peripheral edema. His past medical history was notable for tobacco abuse, essential hypertension, and hyperlipidemia. The physical examination was remarkable for a grade 3 of 6 crescendo-decrescendo systolic murmur that was loudest at the right upper sternal border and radiated throughout the chest. Transthoracic echocardiography showed a heavily calcified aortic valve with profoundly restricted motion. The peak transvalvular gradient and estimated aortic valve area were 78.7 mmHg and 0.58 cm2, respectively, estimated by continuous-wave Doppler echocardiography. These findings were consistent with severe aortic stenosis. There was no evidence of subaortic valvular stenosis or left ventricular (LV) outflow tract obstruction. Mitral and aortic insufficiency of mild and moderate severity, respectively, were also noted. The LV ejection fraction was estimated to be 60%. LV concentric hypertrophy was present, but no regional wall motion abnormalities were observed. A cardiac catheterization confirmed these echocardiographic findings and also showed the presence of hemodynamically significant stenoses in the left anterior descending and left circumflex coronary arteries. The patient was transported to the operating room for aortic valve replacement and coronary artery bypass graft surgery. After anesthetic induction and endotracheal intubation, transesophageal echocardiography (TEE) was performed that revealed the following images (Fig 1, Fig 2, Fig 3 and Videos 1 and 2). What is the diagnosis? Fig 2A modified midesophageal 4-chamber TEE image obtained during left ventricular diastole showing the abnormal structure immediately beneath the anterior mitral leaflet. View Large Image Figure Viewer Download Hi-res image Fig 3A modified midesophageal 4-chamber color-flow Doppler image showing the abnormal structure immediately beneath the anterior mitral leaflet and mild mitral regurgitation directed away from the prolapsing segment (see text). View Large Image Figure Viewer Download Hi-res image" @default.
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- W2010383816 date "2010-02-01" @default.
- W2010383816 modified "2023-10-18" @default.
- W2010383816 title "A Rare Cause of Mitral Regurgitation in an Elderly Man Undergoing Aortic Valve Replacement" @default.
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- W2010383816 doi "https://doi.org/10.1053/j.jvca.2008.09.023" @default.
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