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Three-dimensional echocardiography of mitral Barlow's disease with infective endocarditis: Perforations or cleft-like

Bo Pang1, Yonghuai Wang1, Shuang Liu1

  • 1The Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China.

Journal of Clinical Ultrasound : JCU
|January 29, 2019
PubMed

Insights

Barlow's disease with infective endocarditis can present with cleft-like indentations (CLIs) mimicking perforations. Three-dimensional echocardiography accurately diagnosed CLIs, unlike 2D echocardiography, aiding mitral regurgitation evaluation.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Pathology

Background:

  • Barlow's disease is a complex degenerative mitral valve (MV) condition.
  • Infective endocarditis (IE) frequently complicates primary heart diseases, potentially causing valve perforations.

Observation:

  • This report details a rare case of Barlow's disease co-occurring with IE and cleft-like indentations (CLIs).
  • CLIs, described as inter-scallop indentations involving at least half the valve, were confirmed intra-operatively and via histopathology.

Findings:

  • Preoperative three-dimensional echocardiography correctly identified CLIs.
  • Two-dimensional transthoracic echocardiography misdiagnosed these CLIs as perforations.

Implications:

  • CLIs should be considered in the differential diagnosis of mitral regurgitation in myxomatous MV disease.
  • Advanced imaging like 3D echocardiography improves diagnostic accuracy for complex MV pathologies.
Keywords:
Barlow's diseasecleft-like indentationsinfective endocarditisthree-dimensional transthoracic echocardiography

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