Assuntos
Angiografia Coronária , Doença Hepática Terminal , Frequência Cardíaca , Ivabradina , Ivabradina/uso terapêutico , Ivabradina/farmacologia , Humanos , Frequência Cardíaca/efeitos dos fármacos , Doença Hepática Terminal/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Angiografia por Tomografia Computadorizada , Feminino , Doença da Artéria Coronariana/tratamento farmacológico , Doença da Artéria Coronariana/diagnóstico por imagem , Fármacos Cardiovasculares/uso terapêutico , Fármacos Cardiovasculares/farmacologia , Benzazepinas/uso terapêutico , Benzazepinas/farmacologia , IdosoRESUMO
Mitral valve surgery (MVS), with repair preferred to replacement, is a common procedure for the treatment of severe primary mitral regurgitation related to leaflet prolapse. Structural complications after MVS include left ventricular outflow obstruction, paravalvular leak and atrial septal defect. Intraoperative transoesophageal echocardiography and predischarge transthoracic echocardiography (TTE) specifically screen for these complications. Ventricular septal defect (VSD), a known complication after aortic valve surgery, is rarely reported after MVS. Recently, unsuccessful valvuloplasty prior to replacement was suggested as a risk factor. We present such a case and explore mechanisms with advanced cardiac imaging. In this case, the patient was found to have an elongated membranous septum that likely predisposed her to septal injury. Finally, we provide guidance on specific transoesophageal/transthoracic echocardiography views to avoid a missed diagnosis.