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Atrioventricular Disruption After Aortic Valve Surgery: Early Detection by Intraoperative Echocardiography: A Case Report

Sreeram, Gautam MD*; Hyatt, Darren MD*; Fischer, Sophia MD; Thourani, Vinod H. MD; Duggan, Michael MD, FASE*

doi: 10.1213/XAA.0000000000000692
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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.

Funding: None.

Conflicts of Interest: See Disclosures at the end of the article.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website.

Address correspondence to Darren Hyatt, MD, Physician Specialists in Anesthesia, 5671 Peachtree Dunwoody Rd, Suite 610, Atlanta, GA 30342. Address e-mail to dhyatt@emory.edu.

Copyright © 2018 International Anesthesia Research Society
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