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- W44509749 abstract "A 57-year-old man with a history of uncontrolled hypertension, diabetes mellitus, and renal transplantation presented with acute pulmonary edema and syncope. A loud blowing diastolic murmur was heard at the right upper sternal border. Transthoracic echocardiography showed moderate-to-severe aortic regurgitation (AR) with a vena contracta width of 0.9 cm and a 40% ratio of color Doppler jet width to left ventricular (LV) outflow tract width. There was concentric LV hypertrophy with normal LV systolic function, a dilated left atrium (5.1 cm), and moderate LV diastolic dysfunction. Transesophageal echocardiography (TEE) revealed a normal-appearing trileaflet aortic valve, a normal thoracic aorta, and severe AR. Throughout ventricular diastole, blood flowed from the left main coronary artery into the aorta (Fig. 1). Coronary angiography showed normal coronary arteries.Fig. 1 A) Transesophageal echocardiographic short-axis view of the aortic valve and left main coronary artery (arrow) in diastole. B) Color Doppler shows flow away from the left main coronary artery into the aortic valve (arrow) during diastole.The patient underwent successful aortic valve replacement with a 23-mm On-X® bileaflet mechanical valve (On-X Life Technologies, Inc; Austin, Texas). The immediate postoperative TEE showed a normally functioning prosthetic valve with no AR and no diastolic flow reversal in the left main coronary artery. The excised aortic valve showed mild focal fibrous thickening, mainly at the free margins (Fig. 2).Fig. 2 Pathology specimen shows a tricuspid aortic valve with mildly thickened margins." @default.
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- W44509749 date "2012-01-01" @default.
- W44509749 modified "2023-09-23" @default.
- W44509749 title "Diastolic left main coronary flow reversal as a marker of severe aortic regurgitation." @default.
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