• A&A practice · Jun 2019

    Case Reports

    Crossed Swords Sign: A 3-Dimensional Echocardiographic Appearance.

    • Zhifeng Gao, Jeffrey M Bortman, Feroze Mahmood, Robina Matyal, and Kamal R Khabbaz.
    • From the Department of Anesthesiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
    • A A Pract. 2019 Jun 3; 12 (11): 416-419.

    AbstractIntraoperative evaluation of mitral regurgitation is a complex undertaking. Bileaflet prolapse/flail can result in divergent mitral regurgitation jets with a characteristic "crossed swords sign" appearance. We present a case of divergent mitral regurgitation jets that were detected intraoperatively and evaluated using 3-dimensional imaging. The accurate assessment of eccentric mitral regurgitation jets, especially bilateral eccentric mitral regurgitation jets, is challenging before surgical repair. Intraoperative 3-dimensional transesophageal echocardiography with and without color-flow Doppler can significantly improve the localization of the anatomical lesion.

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