[Complementarity of transthoracic and transesophageal Doppler echocardiography in the diagnosis of thrombosis of a mitral prosthesis. Apropos of 3 cases].
The diagnosis of partial thrombosis of mitral disc valve prostheses is particularly difficult because the clinical presentation is often atypical and the motion of the two hemi-discs is hard to analyse by transthoracic echocardiography. The authors report three cases of partial thrombosis of mitral double-disc valve prostheses. It was not possible to analyse the motion of the two hemi-disc correctly in any of the three patients. The mitral transprosthetic flow recorded by continuous wave Doppler was abnormal with respect to the reference postoperative recording. In addition, in one case, an abnormal echo was observed floating in the left ventricular inflow tract and was suggestive of a thrombus. Transesophageal echo showed abnormal motion of one of the hemi-discs. In two patients this consisted in immobility of the hemi-disc in the semi-closed position; in the other patient, limited excursion of the hemi-disc was recorded. Abnormal retrograde flow in the left atrium was observed in 2 cases and abnormal echoes on the atrial surface of the valve were recorded in one case. After fibrinolysis the transthoracic and transesophageal Doppler echocardiographic parameters returned to normal. These three cases underline the complementarity of transthoracic and transesophageal echocardiography in the diagnosis of dysfunction of mitral disc valve prostheses.
Roudaut
R
R
Centre hospitalier régional et universitaire de Bordeaux, hôpital cardiologique, Pessac.
Gosse
P
P
Reynaud
P
P
Leherissier
A
A
Dallocchio
M
M
D000328:Adult; D000368:Aged; D015150:Echocardiography, Doppler / Q000379:methods*; D004947:Esophagus; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve; D011247:Pregnancy; D011475:Prosthesis Failure; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000175:diagnosis* / Q000188:drug therapy
Complémentarité de l'échocardiographie-doppler transthoracique et transoesophagienne dans le diagnostic des thromboses sur prothèses valvulaires mitrales à double ailette. A propos de 3 cas.