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Stuck on a diagnosis: prosthetic mitral valve thrombosis vs dyssynchrony


Prosthetic valve thrombosis is a rare but serious complication of mechanical valve replacement requiring prompt diagnosis and treatment. Unfortunately, it is often difficult to evaluate this based on single modality imaging alone. We demonstrate a case where the use of both 3D-TOE and valve fluoroscopy allowed for the differentiation between prosthetic valve thrombosis vs prosthetic mitral valve dyssychrony. Using transoesphageal echocardiography, it is noted that there is valve dyssynchrony; however, it is unclear if there is leaflet restriction (Video 1). Using fluoroscopy, it can be seen clearly that their overall mobility is normal (Video 2). Additionally, using 3D-TOE it can be clearly noted that there is no evidence of pannus or thrombus (Video 3). Using these two imaging modalities in concert facilitated the clear diagnosis of valve dyssynchrony vs valve thrombosis.


This work did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.

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Correspondence to Patrick Savage MB BCh BAO BSc MRCP.

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Savage, P., Connolly, M. Stuck on a diagnosis: prosthetic mitral valve thrombosis vs dyssynchrony. Echo Res Pract 7, I9 (2020).

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