PMC4096331_01
Midesophageal long-axis view demonstrating restricted mobility of the mechanical valve leaflet causing eccentric flow into the left ventricular outflow tract (LVOT). Note significant shadowing from the mechanical mitral valve leaflets. LA = Left Atrium; * = LVOT; RV = Right Ventricular; LV = Left Ventricle; Ao = Aorta.
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A midesophageal long-axis view with color flow Doppler demonstrated severe turbulence in the left ventricular outflow tract (LVOT) during diastole suggesting severe aortic regurgitation (Fig. 1; Video 2).
Continuous wave Doppler through the left ventricular outflow tract (LVOT) in a deep transgastric long-axis view, which demonstrates higher velocity flow after mitral valve opening rather than aortic valve closing. This finding is consistent with mitral inflow. In addition, the peak flow velocity is less than 2 m/sec, which is also consistent with mitral inflow in a patient with mitral stenosis.
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Furthermore, spectral Doppler demonstrated higher velocity flow, of less than 2.0 m/sec, after mitral valve opening rather than aortic valve closing, consistent with mitral inflow (Fig. 2).