Abstract
A 53 year old gentleman with previous tissue AVR and mitral valve repair in 2011 was admitted for redo AVR and MVR. On perioperative TOE we noted an echogenic structure projecting into the left atrium just above the anterior mitral valve leaflet. It was difficult to characterise on 2D TOE but 3D TOE views immediately revealed it was the mitral annuloplasty ring which had detached from the posterior annulus.
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