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European Journal of Echocardiography 2005 6(4):297-300; doi:10.1016/j.euje.2004.10.010
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Copyright © 2004, The European Society of Cardiology

Underestimation of severity of mitral regurgitation with varying hemodynamics

A.J.H.A. Scholtea,*, E.R. Holmana, M.C.P. Haverkampa, D. Poldermansb, E.E. van der Walla, R.A.E. Dionc and J.J. Baxa

aDepartment of Cardiology, Leids University Medical Center, Albinusdreef 2, Postbus 9600, 2300 RC Leiden, The Netherlands
bDepartment of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands
cDepartment of Cardiothoracic Surgery, Leids University Medical Center, Leiden, The Netherlands

Received 6 July 2004; received in revised form 11 October 2004; accepted after revision 25 October 2004.

* Corresponding author. Tel.: +31 71 5262020; fax: +31 71 5266809. E-mail: a.j.h.a.scholte@lumc.nl


  Abstract

Transesophageal echocardiography (TEE) is a valuable technique to assess mitral valve anatomy and the mechanism of mitral regurgitation (MR). We present the case of a 35-year-old woman with severe MR due to restrictive motion of the posterior mitral leaflet, who was referred for mitral annuloplasty. Under physiologic circumstances, a severe (grade 3+) MR was present, whereas in the operating room during general anesthesia, the MR had disappeared almost completely. The downgrading of MR due to general anesthesia and the associated mechanisms of this phenomenon are discussed in this case.

Keywords: Transesophageal echocardiography; Mitral regurgitation; Anesthesia


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