Marked mitral prosthesis rocking motion preceding atrioventricular groove rupture

Area of Science:

• Cardiovascular Surgery
• Cardiac Imaging
• Biomedical Engineering

Background:

• Mitral valve replacement is a critical cardiac procedure.
• Atrioventricular groove rupture is a rare but severe complication.
• Prosthetic valve dysfunction requires careful monitoring.

Observation:

• A 74-year-old male developed atrioventricular groove rupture post-mitral valve replacement.
• Excessive rocking of the prosthetic valve was noted on pre-discharge echocardiography.
• This rocking movement was previously associated with paravalvular leaks.

Findings:

• This case demonstrates a novel association between excessive prosthetic valve rocking and atrioventricular groove weakness.
• The observed rocking movement served as a predictor of impending sulcus rupture.
• This led to the formation of a pseudoaneurysm.

Implications:

• Transthoracic echocardiography can detect subtle signs of prosthetic valve complications.
• Excessive valvular prosthesis rocking may indicate underlying structural weakness beyond paravalvular issues.
• Early recognition of this sign can potentially prevent catastrophic events like atrioventricular groove rupture.