Iatrogenic injury of aortic valve leaflet during mitral valve replacement: A transesophageal echocardiographic finding

Abstract

Iatrogenic aortic valve injury during non-aortic cardiac surgery is an infrequent complication. Iatrogenic aortic regurgitation (AR) has been reported after mitral valve repair, aortic valve repair, septal myomectomy, closure of the ventricular septal defect, and atrial septal defect repair. Various causes have been reported for AR after non-aortic cardiac surgery. Perforation of the aortic valve leaflet is a common cause of AR. Other causes of AR are leaflet tension and leaflet retraction due to inadvertent suture placement. A few previous case reports have presented severe AR as a complication of iatrogenic involvement of aortic valve leaflet during MV surgery. We report a case of severe AR and severe aortic stenosis occurring immediately after mitral valve replacement. This was diagnosed intraoperatively by Transesophageal echocardiography (TEE) and aortic valve replacement was done.