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Intra-cardiac echocardiography in mitral valve repair: a novel use of a complimentary imaging modality in a difficult scenario
  1. N C Edwards1,2,
  2. M Griffiths3,
  3. R P Steeds2
  1. 1Department of Cardiovascular Medicine, University of Birmingham, Birmingham, UK
  2. 2Department of Cardiology, Queen Elizabeth Hospital Birmingham, Birmingham, UK
  3. 3Ultrasound, Biosense Webster, Wokingham, UK
  1. Correspondence to Dr Nicola Edwards, Clinical Lecturer, Department of Cardiovascular Medicine, University of Birmingham, Medical School, Birmingham B15 2TT, UK; n.c.edwards{at}

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A 75-year-old man underwent elective preoperative transesophageal echocardiography (TOE) in view of worsening symptomatic severe mitral regurgitation (MR). Intubation was uneventful but mid-oesophageal images were unexpectedly of poor quality. Prolapse of the P2 scallop of the posterior mitral valve (MV) was confirmed using two-dimensional and three-dimensional TOE (figure 1A,B, online supplementary video 1 and 2) with severe anteriorly directed MR (figure 1C,D, online supplementary video 3 and 4). However, transgastric views could not be obtained due to resistance on advancing the probe beyond 40 cm and the procedure was abandoned. …

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  • Contributors NCE and RPS devised the manuscript. All authors were involved in the clinical case and approved the final manuscript.

  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data can be shared as requested.