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An abnormal chamber-like structure after mitral valve replacement
  1. Yu Kang1,
  2. Ritai Huang2,
  3. Ben He1
  1. 1 Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
  2. 2 Department of Cardiovascular Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
  1. Correspondence to Ben He, Department of cardiology, Renji hospital, School of medicine,Shanghai Jiaotong University, No. 1630 Dongfang Rd, Shanghai 20126 , China; heben{at}medmail.com.cn

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Clinical introduction

A 59-year-old woman who underwent mitral valve replacement and tricuspid annuloplasty with the De Vega technique without a rigid ring 16 years ago for rheumatic mitral stenosis was referred to our hospital for aggressive dyspnoea and oedema of lower extremities refractory to diuretics. ECG showed atrial fibrillation. Transthoracic echocardiography reveal ed severe tricuspid regurgitation, preserved left and right ventricular systolic function, slightly elevated systolic pulmonary artery pressure and an abnormal chamber-like structure (see online supplementary video A). Hence, transoesophageal echocardiography (TE) was performed (figure 1, see online supplementary video B).

Supplementary video

[1.avi]

Supplementary video

[2.avi]
Figure 1

Mid-oesophageal four-chamber view of transoesophageal echocardiography.

Question

What is the diagnosis of this abnormal chamber-like structure?

  1. Left …

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