Echocardiographic evaluation of mitral valve repair by modified "edge to edge" technique.

The "edge to edge" or "double-orifice" technique is an alternative surgical option of mitral valve repair to treat mitral regurgitation. Echocardiography is very useful to evaluate the postoperative valve function, but since this technique is not frequently used, there is little experience about its echocardiographic features, which are different from those of the classic mitral valve repair. In this report, we present a patient who underwent this repair with a modified approach called "triple-orifice technique" and was evaluated by transthoracic and transesophageal echocardiography.

Monozygotic twins with Marfan's syndrome and ascending aortic aneurysm.

Marfan's syndrome is a hereditary connective tissue disease, in which cardiovascular abnormalities (especially aortic root dilatation) are the most important cause of morbidity and mortality. In this report, we describe two 24-year-old twins, with a history of surgery for lens subluxation and severe cardiovascular manifestations secondary to Marfan's syndrome. One of the twins suffered a type A aortic dissection, which required replacement of the ascending aorta, and the other twin had an aneurysmal dilatation of the ascending aorta (46mm) and was prescribed medical treatment with atenolol and periodic controls to detect the presence of a critical diameter (50mm) that would indicate the need for prophylactic surgery.

Acute mitral valve dysfunction due to leaflet escape in a Tri-technologies bileaflet mechanical valve.

Acute prosthetic valve dysfunction due to leaflet escape is a mode of structural valve failure of mechanical prostheses which is associated with a high mortality. In this report, we describe the case of a 32-year-old patient, who underwent mitral valve replacement with a Tri-technologies bileaflet valve three years ago, and was admitted to the hospital on August 2005, in cardiogenic shock. He discontinued oral anticoagulation therapy four months ago.