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Figure 4 Slow deceleration mitral regurgitation associated with nonhemolytic failure of mitral valve repair. Off-axis transverse plane TEE imaging. (A) Gross dehiscence (large arrow) of the lateral aspect of a Duran annuloplasty ring (arrowheads) placed 13 months earlier is readily evident. (B) The para-ring defect is so large that prominent diastolic inflow (large arrow), entering the LV adjacent to the annuloplasty ring (arrowheads), is present on color Doppler imaging. (C) During systole, a large regurgitant volume is entrained (small arrows) into the para-ring site of dehiscence on the ventricular aspect of the annuloplasty ring (arrowheads) and a broad eccentric jet of mitral regurgitation (large arrows) adheres to the lateral freewall of the LA. No hemolysis was caused by this type of regurgitant jet as rapid flow acceleration did not occur through this large regurgitant orifice.
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