• Thierry V Scohy, Christian Lüthen, Jackie McGhie, and Frans Oei.
• Department of Anesthesiology, Erasmus Medical Center, Room Bd 581, Dr Molenwaterplein 40, 3015 CE Rotterdam, The Netherlands.
• Interact Cardiovasc Thorac Surg. 2011 May 1; 12 (5): 840-1.

AbstractA 61-year-old patient with the diagnosis of acute heart failure based on severe mitral valve insufficiency due to chordae rupture was scheduled for surgery. Intraoperatively, a standard two-dimensional transesophageal echocardiogram (2D-TEE) examination, revealed severe mitral valve regurgitation due to a prolaps with chordal rupture and an echo dense structure in the pulmonary artery (PA). Because it was not possible to visualize this echo dense structure fully with 2D-TEE we performed a three-dimensional transesophageal echocardiogram (3D-TEE). On the basis of the clear demonstration on 3D-TEE of an at least 6-cm thrombus in the PA we decided to remove the thrombus prior to proceeding with the mitral valve repair. We conclude that 3D-TEE can alter surgical management and provide more valuable information on PA thrombus than that obtained by 2D-TEE.

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