PMC7640564_01
A: TTE parasternal long-axis view, note the flow acceleration at the lower half of the AV while no flow in the upper half. B: TEE LVOT view at 130 degrees, note the accelerated flow in the upper part of AV. C: TEE modified long axis view showed the color flow only from one half of the AV. D: X-plan at LVOT showed one moving AV leaflet.
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On TTE parasternal long-axis view, flow acceleration at the lower half of the AV was seen, while no flow was seen in the upper half (Fig. 1A). On TEE left ventricular outflow tract (LVOT) view showed accelerated flow in the upper part of AV (Fig. 1B), and on modified long axis view the color flow was only from one half of the AV (Fig. 1C). X-plan at LVOT showed one moving AV leaflet (Fig. 1D).
A: Fluoroscopy showed stuck one of the AV leaflets in a closed position. B: Continuous doppler flow on AV, the mean PG is 34 mmHg. C: After 48 h of Alteplase the stuck leaflet was released.
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Fluoroscopy confirmed this diagnosis clarifying stuck one of the AV leaflets in a closed position (Fig. 2A). Continuous doppler flow on AV showed the mean PG of 34 mmHg (Fig. 2B). After 48 h of Alteplase, the stuck leaflet was released (Fig. 2C).
A: TTE after 2 days showed the color flow from both AV leaflets. B: The mean PG across mechanical AV decreased to 16 mmHg.
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The transthoracic parasternal long-axis view showed the color flow acceleration through both AV leaflets (Fig. 3A). The mean pressure gradient dropped to 16 mmHg. (Fig. 3B).