Atrioventricular groove separation is a rare complication of mitral valve surgery. We present a case occurring during aortic valve surgery that was detected by the anesthesiologist using transesophageal echocardiography (TEE). During weaning from cardiopulmonary bypass after uneventful replacement of a severely calcified aortic valve, blood flow was seen on TEE leaving the left ventricular outflow tract just below the annulus of the aortic valve. This blood flow expanded into the aorto-mitral curtain during systole, consistent with atrioventricular groove separation. We review the pathophysiology behind groove separations and discuss diagnosis of these rare conditions using TEE.
From the *Department of Anesthesia, Emory University School of Medicine, Atlanta, Georgia
†Department of Anesthesia, Kendall Regional Anesthesia Associates, Miami, Florida
‡Department of Surgery, Emory University School of Medicine, Atlanta, Georgia.
Accepted for publication October 6, 2017.
Conflicts of Interest: See Disclosures at the end of the article.
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Address correspondence to Darren Hyatt, MD, Physician Specialists in Anesthesia, 5671 Peachtree Dunwoody Rd, Suite 610, Atlanta, GA 30342. Address e-mail to firstname.lastname@example.org.