Figure 1.
Preprocedure transthoracic echocardiogram. (A) Color Doppler map shows a tricuspid regurgitation jet that is impinging on the myocardial wall. (B) Color Doppler shows turbulent flow across the stenotic mitral valve. (C) Continuous-wave (CW) Doppler across the mitral valve shows the mean gradient of 18 mm Hg at a heart rate of 66 bpm. RA: right atrium; RV: right ventricle; LA: left atrium; LV: left ventricle; TR: tricuspid regurgitation; MS: mitral stenosis
Figure 2.
Preprocedure transesophageal echocardiogram. (A) Severely stenotic mitral valve as visualized on transesophageal echocardiogram. (B) Reconstruction of mitral valve visualized during diastole by 3-dimensional echocardiography. (C) Wide open tricuspid regurgitation jet seen during systole. LA: left atrium; LV: left ventricle; RA: right atrium; RV: right ventricle
Figure 3.
Intraprocedural fluoroscopy. (A) Fluoroscopy (RAO projection) showing a 23-mm Edwards Sapien valve in the mitral position after deployment and dilatation with a balloon. (B) Fluoroscopy (LAO projection) showing a 29-mm Edward Sapien valve in the tricuspid position and a 23-mm Edward Sapien valve in the mitral position.
Figure 4.
Intraprocedural transesophageal echocardiogram. (A) Reconstruction of the mitral valve visualized during diastole by 3-dimensional echocardiography after deployment of a 23-mm Edwards Sapien 3 valve. (B) Continuous-wave (CW) Doppler across the mitral valve shows the mean gradient of 5 mm Hg at a heart rate of 74 bpm after deployment of a 23-mm Edwards Sapien 3 valve.