CLINICAL IMAGE
Anterior mitral leaflet perforation: a rare complication of radiofrequency ablation for paroxysmal supraventricular tachycardia Jiancheng Han
, Jin Xu & Yihua He
Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
Correspondence Yihua He, Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, No.2, Anzhen Road, Chaoyang District, Beijing 100029, China. Tel: +86 10 64456450; Fax: +86 10 64456449; E-mail: [email protected]
Key Clinical Message
Funding Information No sources of funding were declared for this study.
Keywords
A 9-year-old girl with a ten-day history of palpitations was referred for the assessment of mitral regurgitation. She had had RF ablation for paroxysmal supraventricular tachycardia 5 years previously. Echocardiography showed isolated anterior mitral leaflet perforation. Surgical findings confirmed the echocardiographic assessment.
Anterior mitral leaflet, perforation, radiofrequency ablation.
Received: 24 September 2015; Revised: 11 April 2017; Accepted: 10 May 2017 Clinical Case Reports 2017; 5(8): 1414–1415 doi: 10.1002/ccr3.1037
A 9-year-old girl with a ten-day history of palpitations was referred for the assessment of mitral regurgitation. She had had RF ablation for paroxysmal supraventricular tachycardia (PSVT,left accessary pathway) 5 years previously. Her cardiac auscultation revealed a III/VI systolic murmur at the left upper sternal border with no other abnormalities. Two-dimensional transthoracic echocardiography and color flow mapping showed isolated anterior
(A)
mitral leaflet (AML) perforation (Fig. 1A) with severe mitral regurgitation (MR) (Fig. 1B). Real-time threedimensional transthoracic echocardiography viewed from the left ventricle (LV) revealed a hole in the A2 region near the anterior annulus of the AML (Fig. 2A). Real-time three-dimensional color flow full volume imaging showed severe MR originating from the AML perforation (Fig. 2B). Surgical findings confirmed the
(B)
Figure 1. Parasternal left ventricular long-axis view: Two-dimensional transthoracic echocardiography showed anterior mitral leaflet perforation (arrow). Parasternal left ventricular long-axis view: Two-dimensional color Doppler imaging showed severe mitral regurgitation (arrow). LA, left atrium; LV, left ventricle.
1414
ª 2017 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
J. Han et al.
Anterior mitral leaflet perforation
(A)
(B)
Figure 2. Real-time three-dimensional transthoracic echocardiography revealed a hole in the A2 region (arrow) near to the anterior annulus of the anterior mitral leaflet (AML). Real-time three-dimensional color flow full volume imaging showed severe MR originated from anterior mitral leaflet perforation (arrow). PML, posterior mitral leaflet.
echocardiographic assessment. The perforation was repaired with a patch of fresh autologous pericardium. Postoperative echocardiography showed trace central mitral regurgitation.
Conflict of Interest None declared.
Authorship JH: performed the echo and wrote the manuscript. JX: collected the clinical data. YH: provided the scientific direction of the manuscript.
ª 2017 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.
1415
Anterior mitral leaflet perforation: a rare complication of radiofrequency ablation for paroxysmal supraventricular tachycardia Jiancheng Han
, Jin Xu & Yihua He
Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
Correspondence Yihua He, Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, No.2, Anzhen Road, Chaoyang District, Beijing 100029, China. Tel: +86 10 64456450; Fax: +86 10 64456449; E-mail: [email protected]
Key Clinical Message
Funding Information No sources of funding were declared for this study.
Keywords
A 9-year-old girl with a ten-day history of palpitations was referred for the assessment of mitral regurgitation. She had had RF ablation for paroxysmal supraventricular tachycardia 5 years previously. Echocardiography showed isolated anterior mitral leaflet perforation. Surgical findings confirmed the echocardiographic assessment.
Anterior mitral leaflet, perforation, radiofrequency ablation.
Received: 24 September 2015; Revised: 11 April 2017; Accepted: 10 May 2017 Clinical Case Reports 2017; 5(8): 1414–1415 doi: 10.1002/ccr3.1037
A 9-year-old girl with a ten-day history of palpitations was referred for the assessment of mitral regurgitation. She had had RF ablation for paroxysmal supraventricular tachycardia (PSVT,left accessary pathway) 5 years previously. Her cardiac auscultation revealed a III/VI systolic murmur at the left upper sternal border with no other abnormalities. Two-dimensional transthoracic echocardiography and color flow mapping showed isolated anterior
(A)
mitral leaflet (AML) perforation (Fig. 1A) with severe mitral regurgitation (MR) (Fig. 1B). Real-time threedimensional transthoracic echocardiography viewed from the left ventricle (LV) revealed a hole in the A2 region near the anterior annulus of the AML (Fig. 2A). Real-time three-dimensional color flow full volume imaging showed severe MR originating from the AML perforation (Fig. 2B). Surgical findings confirmed the
(B)
Figure 1. Parasternal left ventricular long-axis view: Two-dimensional transthoracic echocardiography showed anterior mitral leaflet perforation (arrow). Parasternal left ventricular long-axis view: Two-dimensional color Doppler imaging showed severe mitral regurgitation (arrow). LA, left atrium; LV, left ventricle.
1414
ª 2017 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
J. Han et al.
Anterior mitral leaflet perforation
(A)
(B)
Figure 2. Real-time three-dimensional transthoracic echocardiography revealed a hole in the A2 region (arrow) near to the anterior annulus of the anterior mitral leaflet (AML). Real-time three-dimensional color flow full volume imaging showed severe MR originated from anterior mitral leaflet perforation (arrow). PML, posterior mitral leaflet.
echocardiographic assessment. The perforation was repaired with a patch of fresh autologous pericardium. Postoperative echocardiography showed trace central mitral regurgitation.
Conflict of Interest None declared.
Authorship JH: performed the echo and wrote the manuscript. JX: collected the clinical data. YH: provided the scientific direction of the manuscript.
ª 2017 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.
1415
