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A 68-year old man developed heart failure 15 days after coronary bypass surgery and mitral repair with an annuloplasty ring. Transthoracic and transoesophageal echocardiogram (TEE) showed a severe eccentric mitral regurgitation. Three-dimensional TEE revealed the exact anatomic characteristics of the annulus dehiscence. This technique is useful in planning the intervention properly. Figure 1: (A) Transthoracic echocardiography with eccentric mitral regurgitation. (B) TEE confirming the eccentric mitral regurgitation. 3D TEE showing the location and anatomic characteristics of the annulus dehiscence, mimicking a 'D' letter (C, arrow, and D).

Usefulness of 3D transoesophageal echocardiography in the evaluation of prosthetic valve dehiscence