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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.
Systolic and diastolic frames showing open and stuck (arrow) mitral valve leaflets.
Asymmetric colour flow through single open mitral valve leaflet.
Continuous wave Doppler through mitral valve with peak forward flow velocity of 3 m/s.
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