An Unusual Left Ventricular Outflow Tract Obstruction, or Just Another Artifact?

Abstract

A 71-YEAR old female (75 kg, 157 cm), with a remote history of coronary artery bypass grafting and aortic valve replacement, presented with worsening chest pressure and shortness of breath. She was found to have a patent coronary graft, a normal functioning bioprosthetic aortic valve, and a new diagnosis of severe annular calcific mitral stenosis, with a mean valvular gradient of 14 mmHg and pulmonary capillary wedge pressure of 26 mmHg (Fig 1). The patient was taken to the operating room for mitral valve replacement through a transatrial approach, using a Sapien Ultra Tissue Valve (Edwards Lifesciences, Irvine, CA) prosthesis.