A Confounding Mobile Mass Observed in Transthoracic Echocardiography After Mitral Valve Replacement Performed by the Preservation of the Native Mitral Apparatus

Severe mitral regurgitation is associated with significant morbidity and mortality. Mitral valve repair or mitral valve replacement is recommended for symptomatic patients. Preservation of the subvalvular apparatus has the merits of postoperative outcomes during mitral valve replacement for mitral regurgitation. We report a case of a remnant mitral subvalvular apparatus detected by echocardiography after chordal preserving mitral valve replacement. It was performed as mitral valve replacement with posterior leaflet chordal preservation in a 44-year-old male patient due to rheumatic, symptomatic severe mitral regurgitation. On the third postoperative day, routine postoperative trans-thoracic echocardiography showed an unknown mobile mysterious formation in the left ventricle. We clarified the mysterious mass with the help of laboratory, blood culture and serial echocardiographic assessment and presented this case. We emphasize the importance of post-operative echocardiographic evaluation and a complete evaluation of the patients who have undergone mitral valve replacement. Serial echocardiographic evaluation is the main part of this assessment.