PMC9313924_01
Postoperative day 2 TEE demonstrating two distinct regurgitant jets by color flow Doppler (CFD) with a common origin in the LVOT communicating with both the RA and LA. (a) 2D CFD of the mid-esophageal four-chamber view that has been cropped and (b) 3D CFD full-volume reconstruction (Philips X8-2t probe, Cambridge, MA).
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fig1
TEE performed during this time, utilizing 2D and 3D full-volume reconstruction with color flow Doppler overlay (Philips X8-2t probe, Cambridge, MA), demonstrated two distinct color flow jets occurring during systole (Figure 1) and, to a lesser extent, diastole (Figure 2) with a common origin in the LV outflow tract (LVOT) that communicated with both the RA and LA.
2D mid-esophageal four-chamber view with CFD demonstrating biatrial regurgitant jets originating in the LVOT and occurring into diastole (Philips X8-2t probe, Cambridge, MA).
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fig2
TEE performed during this time, utilizing 2D and 3D full-volume reconstruction with color flow Doppler overlay (Philips X8-2t probe, Cambridge, MA), demonstrated two distinct color flow jets occurring during systole (Figure 1) and, to a lesser extent, diastole (Figure 2) with a common origin in the LV outflow tract (LVOT) that communicated with both the RA and LA.
En face representation of the intervalvular fibrous trigone and the likely location of the injury to the area of the right fibrous trigone (red circle) that is in continuity with the LVOT and the inferior portion of the interatrial septum (Figure 1).
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fig3
The perforation originated in the LVOT and violated the right fibrous trigone and the inferior interatrial septum (Figure 3).