PMC9850851_01
Intraoperative photograph of the Tricuspid valve. Notably shrunken valve leaflet due to fibrosis. Fibrosis also extended to the chordae and papillary muscles causing decreased valve movement and inability to close sufficiently. Maximum range of movement demonstrated by the hooks under the point of attachment of chordae.
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The tricuspid valve leaflets and chordae showed sclerotic thickening with inward rolling (Figure 1).
Doppler echocardiogram of the preoperative pulmonary valve showing stenosis in systole. The arrow indicates the position of the valve.
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The pulmonary valve showed a Vmax 2.8 m/s, dp max/mean 31/18 mmHg (Figures 2 and 3), and the tricuspid valve had a Vmax 1.5 m/s, dp mean 5-6 mmHg with no relevant paravalvular leakage around either bio prosthesis (Figures 4 and 5).
Doppler echocardiogram of the postoperative pulmonary valve. The arrow indicates the position of the valve.
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The pulmonary valve showed a Vmax 2.8 m/s, dp max/mean 31/18 mmHg (Figures 2 and 3), and the tricuspid valve had a Vmax 1.5 m/s, dp mean 5-6 mmHg with no relevant paravalvular leakage around either bio prosthesis (Figures 4 and 5).
Doppler echocardiogram of the preoperative tricuspid valve showing insufficiency in systole. The arrow indicates the position of the valve.
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The pulmonary valve showed a Vmax 2.8 m/s, dp max/mean 31/18 mmHg (Figures 2 and 3), and the tricuspid valve had a Vmax 1.5 m/s, dp mean 5-6 mmHg with no relevant paravalvular leakage around either bio prosthesis (Figures 4 and 5).
Doppler echocardiogram of the postoperative tricuspid valve. The arrow indicates the position of the valve.
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The pulmonary valve showed a Vmax 2.8 m/s, dp max/mean 31/18 mmHg (Figures 2 and 3), and the tricuspid valve had a Vmax 1.5 m/s, dp mean 5-6 mmHg with no relevant paravalvular leakage around either bio prosthesis (Figures 4 and 5).
Photograph taken from the MRI of the right ventricular outflow tract. The arrow shows the eddies caused by the stenotic pulmonary valve in systole.
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A better flow profile was observed over the pulmonary valve as compared to the preoperative MRI (Figure 6).