Diagnosis of Mechanical Mitral Valve Stenosis Using Live Transoesophageal Three‐Dimensional Multivue Imaging: A Case Report

ABSTRACT

A 61‐year‐old woman presented with progressive chest tightness and dyspnoea 17 years after mechanical mitral valve replacement. Transthoracic echocardiography (TTE) showed an elevated transprosthetic velocity, raising suspicion of prosthetic valve stenosis. Further evaluation with live three‐dimensional transoesophageal echocardiography (3D TOE) using Philips Multivue imaging revealed restricted leaflet motion and a small irregular mass on the leaflet surface, findings suggestive of fibrotic pannus ingrowth. The diagnosis was confirmed intraoperatively, and the patient underwent successful redo mitral valve replacement. This case demonstrates that 3D TOE with Philips Multivue imaging can clearly visualise leaflet‐restricting pannus ingrowth without radiation and provide important clinical implications for guiding subsequent management. The technique provides added value over conventional 2D TOE and cine‐fluoroscopy, as it enables multiplanar reconstruction and en‐face views of the prosthetic valve, allowing detailed assessment of leaflet morphology and surface abnormalities that are often difficult to appreciate on 2D imaging, particularly in patients where CT is contraindicated or radiation exposure is a concern.