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Gepubliceerd in: Netherlands Heart Journal 11/2013

01-11-2013 | Imaging in Cardiology

Imaging the prosthetic valve sewing ring thrombosis using real-time three-dimensional transoesophageal echocardiography

Auteurs: C. Alexandrescu, S. L. Negrea, F. Civaia, G. Dreyfus

Gepubliceerd in: Netherlands Heart Journal | Uitgave 11/2013

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Excerpt

A 56-year-old man was admitted for transoesophageal echocardiography (TEE) evaluation before electrical cardioversion of persistent atrial fibrillation to sinus rhythm. He had undergone mitral valve replacement with a bileaflet prosthetic mitral valve (SORIN prosthetic valve) for rheumatic disease 3 months previously. Inadequate anticoagulation was noted with an INR of 1.7. TEE revealed the presence of thick mobile filamentous fibrin strands attached to the prosthesis sewing ring with a diastolic movement within the prosthesis without obstruction (normal 5 mmHg transprosthetic mean pressure gradient) (Fig. 1 and video 1). Three-dimensional transoesophageal echocardiography showed the presence of a circular thrombus like a crown attached to the whole prosthesis sewing ring protruding between the prosthesis leaflets and the sewing ring (Fig. 2 arrows and video 2) highlighting the presence of sewing ring thrombosis when compared with two-dimensional TEE evaluation of the same image. Considering the presence of non-obstructive thrombosis, a conservative approach with heparin was used.
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Literatuur
1.
go back to reference Moreo A, Lobiati E, De Chiara B, et al. Assessment of mitral prosthetic valve thrombosis by live three-dimensional echocardiography: comparison with transesophageal echocardiography. Hear Vessel. 2007;22(4):287–9.CrossRef Moreo A, Lobiati E, De Chiara B, et al. Assessment of mitral prosthetic valve thrombosis by live three-dimensional echocardiography: comparison with transesophageal echocardiography. Hear Vessel. 2007;22(4):287–9.CrossRef
Metagegevens
Titel
Imaging the prosthetic valve sewing ring thrombosis using real-time three-dimensional transoesophageal echocardiography
Auteurs
C. Alexandrescu
S. L. Negrea
F. Civaia
G. Dreyfus
Publicatiedatum
01-11-2013
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Netherlands Heart Journal / Uitgave 11/2013
Print ISSN: 1568-5888
Elektronisch ISSN: 1876-6250
DOI
https://doi.org/10.1007/s12471-011-0217-y

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Editorial Comment

The haemodynamic cascade