Successful thrombolysis of a partially obstructed bileaflet prosthetic heart valve in the mitral position

✍ Scribed by John Barbetseas; Michael Vitalis; Gregory Vyssoulis; Spyros Lambrou; Constantina Aggeli; Nicholas Marinakis; Pavlos Toutouzas

• Publisher: John Wiley and Sons
• Year: 2003
• Tongue: English
• Weight: 128 KB
• Volume: 32
• Category: Article
• ISSN: 0091-2751
• DOI: 10.1002/jcu.10221

✦ Synopsis

Abstract

We describe the case of a woman who presented with dyspnea of abrupt onset and who had recently undergone replacement of the mitral valve with a bileaflet mechanical prosthesis. Transthoracic echocardiographic examination with spectral Doppler recording of transvalvular blood flow revealed a velocity spectrum consistent with obstruction. Transesophageal echocardiography demonstrated partial obstruction of the prosthetic valve due to immobilization of 1 hemidisc in the closed position. This immobilization was apparently caused by a small mass whose appearance was consistent with that of a thrombus. The patient was successfully treated by intravenous administration of a thrombolytic agent. This case demonstrates the value of transesophageal echocardiography in the selection of candidates for thrombolytic treatment in cases of thrombosis of a left‐sided valve prosthesis. © 2003 Wiley Periodicals, Inc. J Clin Ultrasound 32:42–46, 2004