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Successful thrombolysis of a partially obstructed bileaflet prosthetic heart valve in the mitral position
Author(s) -
Barbetseas John,
Vitalis Michael,
Vyssoulis Gregory,
Lambrou Spyros,
Aggeli Constantina,
Marinakis Nicholas,
Toutouzas Pavlos
Publication year - 2004
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.10221
Subject(s) - medicine , thrombolysis , cardiology , thrombus , prosthesis , mitral valve , thrombosis , mitral valve replacement , surgery , myocardial infarction
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