case_images: PMC10876143_01
case_images: Pre-CPB TEE examination showing the assessment of aortic annulus and aortic valve leaflets. (a). Three-dimensional imaging of the aortic valve in short axis view shows prolapsing left coronary cusp (LCC), elongated right coronary cusp (RCC) and a small and restrictive noncoronary cusp (NCC). (b). Measurement of aortic annulus in the mid-esophageal aortic valve long axis view shows a dilated annulus of 31.3 mm. (c). Mid-esophageal aortic valve long axis view showing prolapse of left coronary cusp (LCC) and severe eccentric aortic regurgitation (AR). Abbreviations: 3D, three dimensional; AV, aortic valve; LAX, long axis; ME, midesophageal; SAX, short axis; TEE, transesophageal echocardiography
case_images: ACA-27-53-g001.jpg
case_images: PMC10876143_01_ACA-27-53-g001.jpg
case_images: aca_92_23-f001
case_images: TEE probe (X7-2t; IE33; Philips, Bothell, USA). The TEE examination confirmed the pre-operative TTE findings [Figure 1].
case_images: Post-CPB TEE examination showing the assessment of aortic annulus and residual aortic regurgitation. (a) Measurement of aortic annulus after AV repair in ME AV long axis view; (b) ME AV long axis view (colour compare) shows less than mild residual aortic regurgitation after the aortic valve repair (red arrow). Abbreviations: AA, aortic annulus; AV, aortic valve; CPB, cardiopulmonary bypass; LAX, long axis; ME, mid esophageal; TEE, transesophageal echocardiography
case_images: ACA-27-53-g002.jpg
case_images: PMC10876143_01_ACA-27-53-g002.jpg
case_images: aca_92_23-f002
case_images: Post-CPB, TEE examination revealed an adequate surgical AV repair with trivial AR [Figure 2a; Supplemental Video 1], aortic annulus of 21 mm [Figure 2b], coaptation height of 10.6 mm [Figure 3a], effective height of 16.6 mm [Figure 3b], and transvalvular mean pressure gradient of 9 mm
case_images: Post-CPB TEE examination showing the assessment of aortic root dimensions and transvalvular pressure gradients. (a). Measurement of coaptation height (distance of cusp apposition, measured in the diastolic phase) in the ME AV long-axis view; (b). Measurement of the effective height (distance measured from the aortic annulus to the coaptation tip in diastole) in the ME AV LAX view; (c). Post-CPB TEE continuous wave Doppler measurement of the mean gradient across the AV in deep TG long axis view shows a mean gradient of 9 mmHg across the AV. Abbreviations: AV, aortic valve; CPB, cardiopulmonary bypass; LAX, long axis; ME, midesophageal; TEE, transesophageal echocardiography; TG, transgastric
case_images: ACA-27-53-g003.jpg
case_images: PMC10876143_01_ACA-27-53-g003.jpg
case_images: aca_92_23-f003
case_images: Post-CPB, TEE examination revealed an adequate surgical AV repair with trivial AR [Figure 2a; Supplemental Video 1], aortic annulus of 21 mm [Figure 2b], coaptation height of 10.6 mm [Figure 3a], effective height of 16.6 mm [Figure 3b], and transvalvular mean pressure gradient of 9 mm Hg [Figure 3c].