When Echocardiography Is Challenging in Localizing Bioprosthetic Aortic Regurgitation: Dye Don't Lie

Taha Hatab; Priscilla Wessly; Syed Zaid; Nadeen Faza; Su Min Chang; Neal S Kleiman; Stephen H Little; Sachin S Goel

doi:10.1016/j.jaccas.2023.101853

When Echocardiography Is Challenging in Localizing Bioprosthetic Aortic Regurgitation: Dye Don't Lie

JACC Case Rep. 2023 May 1:15:101853. doi: 10.1016/j.jaccas.2023.101853. eCollection 2023 Jun 7.

Authors

Taha Hatab¹, Priscilla Wessly¹, Syed Zaid¹, Nadeen Faza¹, Su Min Chang², Neal S Kleiman¹, Stephen H Little¹, Sachin S Goel¹

Affiliations

¹ Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA.
² Department of Cardiology, Houston Methodist Debakey Heart and Vascular Center, Houston, Texas, USA.

Abstract

Transesophageal echocardiography is the main imaging modality for localizing and quantifying prosthetic aortic regurgitation. We describe a case of bioprosthetic aortic paravalvular leak (PVL) where transesophageal echocardiography was inadequate; aortic root angiography and computed tomography fusion were critical in diagnosing and guiding closure. Multimodality imaging can be pivotal in localizing PVL and guiding transcatheter PVL closure. (Level of Difficulty: Intermediate.).

Keywords: CT fusion; aortic angiography; multimodality imaging; paravalvular leak.

Publication types

Case Reports