Excerpt

The patient is a 57-year-old female with Down syndrome with a history of a partial atrioventricular (AV) canal defect repair at the age of 10. She presented to the hospital complaining of shortness of breath that has been gradually worsening for the past 3 months. She was found to have severe left-sided valve regurgitation on cardiac echocardiogram (Fig. 1a, b). Multiphase cardiac computerized tomography with post processing reconstruction with Aquarius Workstation (TeraRecon Inc, San Mateo, CA) revealed two defects on the left sided valve; a cleft on the anterior leaflet and a defect at the base of the same leaflet (Fig. 1c, d). Defects seen with 3D transesophageal echocardiography (TEE) and 3D CT reconstruction coincided exactly with the defects visualized during surgery (Fig. 1e, video 1). Mini surgical left sided valve repair was performed with pericardial patch and suture placement (Fig. 1f). No residual left sided regurgitation was seen on post procedure transesophageal echocardiogram. Patient was discharged 4 days later.

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