title: The incremental value of RT three-dimensional TEE in the evaluation of prosthetic mitral valve ring thrombosis complicated with thromboembolism.
abstract: OBJECTIVE
  Although nonobstructive prosthetic valve thrombosis (PVT) does not develop hemodynamic compromise, it carries potential risk for thromboembolism. Real time three-dimensional transesophageal echocardiography (RT-3DTEE), has emerged as a complementary tool in depicting "en face" views of prosthesis compared with two-dimensional transesophageal echocardiography (2DTEE). We aimed to evaluate the utility of RT-3DTEE in assessment of mitral ring-located thrombosis.
  
  
  METHODS
  We present 3 cases of mechanical mitral valve thrombosis complicated by thromboembolism, who were all examined and followed-up by 2D transthoracic echocardiography (TTE), 2DTEE, and RT-3DTEE.
  
  
  RESULTS
  The consequencies of thromboembolism in the patients were coronary embolism, transient ischemic attack, and ischemic stroke, respectively. They were all inadequately anticoagulated at the time of admission. 2DTTE and TEE examination was unsatisfactory; RT-3DTEE depicted nonobstructive mitral ring thrombosis in each of the patients. The patients were followed up under effective anticoagulation and antiplatelet therapy. RT-3DTEE was able to demonstrate the evolution of thrombus size in each of the patients.
  
  
  CONCLUSIONS
  Nonobstructive ring-located PVT which poses risk for thromboembolism, may be diagnosed with certainty and imaged with clarity utilizing RT-3DTEE.
authors.affiliation: Koşuyolu Kartal Heart Training and Research Hospital, Cardiology Department, İstanbul, Turkey. m.ozangursoy@yahoo.com
authors.forename: Ozan Mustafa
authors.initials: OM
authors.lastname: Gürsoy
authors.forename: Süleyman
authors.initials: S
authors.lastname: Karakoyun
authors.forename: Macit
authors.initials: M
authors.lastname: Kalçık
authors.forename: Mehmet
authors.initials: M
authors.lastname: Özkan
mesh_terms: D000328:Adult; D003199:Computer Systems; D003937:Diagnosis, Differential; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000150:complications* / Q000000981:diagnostic imaging*; D013927:Thrombosis / Q000150:complications* / Q000000981:diagnostic imaging*
keywords: prosthetic valve; three-dimensional transesophageal echocardiography; thrombus