Apparent dysfunction of one leaflet of a bileaflet mitral valve prosthesis due to collection of blood behind left atrium following cox maze III procedure and mitral valve replacement

Immediate postcardiotomy tamponade is a known surgical complication predominantly by ventricular compression due to accumulation of ongoing bleeding or clot within the pericardial space. Transeosophageal echocardiography (TEE) is a useful tool in understanding such acute pathology; especially when the clot behind the heart would cause mechanical distortion of the prosthetic valve leaflets in mitral position. The main aim here is to present intraoperative TEE comparison findings to rule out leaflet mechanical obstruction of prosthetic valve during cardiac tamponade, shortly after cut and sew Cox-Maze III procedure, mitral valve replacement and tricuspid valve repair.