No abstract

Not all patients undergoing planned endocardial pulmonary vein isolation need preprocedural TEE. Both scores <2 had an almost maximal negative predictive capability of excluding the presence of a thrombus in the LA/LAA.

Aberrantly inserted chordae tendineae in the left atrial side are a rare find. We report here the case of a young patient with aberrantly inserted chordae tendineae not causing significant mitral regurgitation. Because the patient remained asymptomatic and the anomalous chord of the left atrium could be considered within normal human anatomic variation, the authors decided to only monitor the patient's condition for the time being.

We describe a case of double orifice mitral valve and a flail leaflet in a 54-year-old man. This rare congenital abnormality was disclosed through the discovery of a murmur. The transoesophageal approach clearly showed two approximately equal orifices with multiple papillary muscles. Colour Doppler echocardiography showed a moderate mitral regurgitation due to the prolapse of the posterior leaflet of the anteromedial orifice. No other abnormality was associated. Transoesophageal echocardiography is useful to analyse as well the anatomy as the functional aspect of the mitral apparatus in this particular case of congenital disease.

Papillary fibroelastoma is a rare, benign tumor, and multiple papillary fibroelastomas are even more uncommon. In an asymptomatic patient scheduled for carotid endarterectomy, transthoracic echocardiography discovered a fibroelastoma on the mitral valve. Then, transesophageal echocardiography showed another fibroelastoma on the aortic valve. Because he also needed a right coronary artery bypass, the patient underwent surgical excision of both masses. Fibroelastomas are not always as innocent as they seem, and surgical excision is necessary because of their potential for systemic or coronary embolization. Transoesophageal echocardiography may improve the diagnosis of multiple papillary fibroelastomas.