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Stuck mitral valve replacement
  1. J Pemberton,
  2. T Irvine,
  3. A Kenny
  1. antoinette.kenny{at}

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This 30 year old woman had undergone a mitral valve replacement with a bileaflet prosthesis one year previously. Postoperatively she had been well until she presented with a two week history of shortness of breath and an episode of paroxysmal nocturnal dyspnoea. During this time her anticoagulation had been subtherapeutic. A transoesophageal echocardiogram (TOE) was performed to assess the prosthetic mitral valve. The TOE showed a stuck leaflet caused by thrombus with flow through only one side of the prosthesis.

Continuous wave Doppler through the valve gave an elevated peak forward flow velocity of 3 m/s. After a period of adequate anticoagulation the valve was unchanged and the patient underwent redo mitral valve replacement.

Figure 1

Systolic and diastolic frames showing open and stuck (arrow) mitral valve leaflets.

Figure 2

Asymmetric colour flow through single open mitral valve leaflet.

Figure 3

Continuous wave Doppler through mitral valve with peak forward flow velocity of 3 m/s.

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