Gao, Zhifeng, Jeffrey M Bortman, Feroze Mahmood, Robina Matyal, and Kamal R Khabbaz. 2019. “Crossed Swords Sign: A 3-Dimensional Echocardiographic Appearance.”. A&A Practice 12 (11): 416-19.
Abstract
Intraoperative 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.