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Case Reports in Cardiology
Volume 2013, Article ID 528439, 4 pages
Case Report

Cardiac Gated Computed Tomography Used to Confirm Iatrogenic Aortic Valve Leaflet Perforation after Mitral Valve Replacement

1Department of Internal Medicine, Naval Medical Center San Diego, Suite 301, 34800 Bob Wilson Drive, San Diego, CA 92101, USA
2Department of Cardiology, Naval Medical Center San Diego, San Diego, CA 92101, USA
3Department of Cardiothoracic Surgery, Naval Medical Center San Diego, San Diego, CA 92101, USA
4Department of Radiology, Naval Medical Center San Diego, San Diego, CA 92101, USA

Received 21 January 2013; Accepted 12 February 2013

Academic Editors: J. A. Breall, A. J. Mansur, R. J. Ostfeld, and D. Richter

Copyright © 2013 Luke Oakley et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Aortic insufficiency from iatrogenic valve perforation from nonaortic valve operations is rarely reported despite the prevalence of these procedures. Rapid diagnosis of these defects is essential to prevent deterioration of cardiac function. In this paper, we describe a young man who reported to our institution after two open cardiac surgeries with new aortic regurgitation found to be due to an iatrogenic perforation of his noncoronary aortic valve cusp. This defect was not appreciated by previous intraoperative transesophageal echocardiography and was inadequately visualized on follow-up transthoracic and transesophageal echocardiograms. In contrast, cardiac gated computed tomography clearly visualized the defect and its surrounding structures. This case highlights the utility of cardiac gated computed tomography for cases of suspected valvular perforation when echocardiography is not readily available or inadequate imaging is obtained.