Repair of mitral valve and left atrioventricular disruption caused by blunt chest trauma.

We describe a case of acute cardiac failure in a patient involved in a motor vehicle accident. A diagnosis of acute mitral regurgitation and left atrioventricular disruption was made with transesophageal echocardiography. Successful repair was performed using the mitral valve leaflets to patch the disruption followed by valve replacement.

Flow impeding fungal thrombus in the ascending aorta.

Mycotic endoaortitis is a rarely occurring infectious entity with an extremely high mortality rate. We report an uncommon case of Phialemonium endoaortits with its management. This large fungal thrombus in the ascending aorta caused significant impediment to the blood flow.

Acquired aortic cusp fusion after chronic left ventricular assist device support.

Explanted hearts from patients with chronic left ventricular assist device (LVAD) support have shown the presence of aortic cusp fusion, which results in valvular stenosis and may complicate weaning of a LVAD. This is the first report of aortic cusp fusion diagnosed solely by transesophageal echocardiography (TEE) in vivo in a patient on chronic LVAD support. Under intraoperative TEE guidance, a 41-year-old woman underwent an attempted explantation of a LVAD, which had been implanted 8 months before for dilated cardiomyopathy.

Improved technique to diagnose a patent foramen ovale during left ventricular assist device insertion.

Diagnosis of a patent foramen ovale prior to left ventricular assist device placement can be quite difficult, and if missed may result in a significant hypoxemia due to a right to left shunt. We describe a simple and precise way to increase the diagnostic accuracy of patent foramen ovale detection prior to initiating cardiopulmonary bypass for left ventricular assist device placement.