redo僧帽弁置換術後の術中経食道心エコー検査における機械弁機能不全を模倣したアーチファクト

Intraoperative transesophageal echocardiography (TEE) is vital for assessing prosthetic valve function, but imaging artifacts can lead to misdiagnosis. We describe a case of a 54-year-old man who underwent redo mitral valve replacement with a mechanical prosthesis, in which intraoperative TEE suggested prosthetic leaflet immobility. This prompted surgical re-exploration, which revealed normal valve function. Despite resection of posterior leaflet remnants that may have caused leaflet immobility, the abnormal findings persisted on TEE but were ultimately shown to be artifacts on intraoperative fluoroscopy. This case highlights the potential for TEE artifacts to mimic mechanical valve dysfunction. Multimodal imaging is critical for accurate diagnosis and avoiding unnecessary re-intervention.