I

rZ^H

B 132 180

Figure 7.5. A perforated aneurysm located close to the tip of the anterior mitral leaflet on transesophageal echocardiogra-phy (A). Mitral regurgitation traversing the defect is detected by color flow imaging (B).

Summary

1. IE is the most common cause of valvular perforations or aneurysms in adult patients.

2. Valvular perforation should be suspected when the origin of the regurgitant jet is remote from the area of leaflet coaptation.

3. Perforations are often seen in the presence of valve aneurysms.

4. TEE is more sensitive and specific for diagnosing valvular perforations by direct visualization of leaflet discontinuity.

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