Table 1 Overview of events, treatment, NYHA class, and echocardiographic follow-up
From: Mitral valve repair and redo repair for mitral regurgitation in a heart transplant recipient
Event | Month & year | Treatment | Recipient NYHA class | TTE/TEE | Echocardiographic findings |
|---|---|---|---|---|---|
Heart transplant | June 2006 | − | 4 | Pre-op donor TTE | MR 1+, TR 0, moderate LVF |
Discharge | June 2006 | − | 3 | Pre-discharge TTE | MR 2+, TR1+, moderate LVF (inferoposterior hypokinesia) |
NSTEMI (inferoposterior) | June 2007 | PCI RCA with 2 PRO-kinetic stents | 3 | − | − |
Follow-up | January 2008 | − | 4 | TTE and TEE | MR 4+ (Figure1A), TR 2+, dilatation of the LV and deterioration of LVF |
MR severity: jet surface area (18.5 cm2)/ LA surface area (36.5 cm2) = 51%; vena contracta = 65 mm | |||||
Mitral geometry: annular diameter = 39 mm (TEE, LAX), 40 mm (TTE, PLAX), 43 mm (TTE, AP4CH); intercommissural width = 36 mm (TEE, basal SAX); interpapillary muscle distance = 12 mm (TTE, PSAX); tenting height = 5 mm (TTE, AP4CH), 6 mm (TTE, PLAX); tenting area = 1.0 cm2 (TEE, LAX), 1.1 cm2 (TTE, AP4CH); posterior tethering angle = 20° (TTE, AP4CH); anterior tethering angle = 16° (TTE, PLAX) | |||||
NSTEMI (inferior) | May 2008 | Mitral valve repair (CE classic 32 mm ring); hybrid PCI of the Cx | 2 | Post-op TTE | MR 1+, TR 1+, moderate LVF |
Total AV block | May 2008 | DDD-pacemaker | 2 | − | − |
Follow-up | June 2008 | − | 3 | TTE and TEE | MR 4+ (ring dehiscence) (Figure1B), TR 4+ (Figure1C), moderate LVF |
July 2008 | Redo mitral repair (ring refixation) and tricuspid repair (CE classic 36 mm ring) | 2 | Post-op TTE | MR 1+, TR 1+, moderate LVF | |
August 2008 | − | 2 | TTE | Moderate LVF, intraventricular dyssynchronia | |
September 2008 | Upgrade to CRT-D | 2 | − | − | |
July 2010 | − | 2 | TEE | ||
February 2012 | − | 2 | TTE | MR 1+, TR 1+, moderate LVF |