PMC6134406_01
First fluoroscopy.. Notes: Normal motion in prosthetic aortic valve leaflets; fixation of one leaflet of the prosthetic pulmonary valve was observed.
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Fluoroscopy showed that although the prosthetic aortic valve (PAV) leaflets had normal motion, one of the leaflets of the prosthetic pulmonary valve (PPV) was fixed (Figure 1).
Second fluoroscopy.. Notes: This image was taken 48 hours after reteplase injection; partial, but not complete, improvement of valve mobility was observed.
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After 48 hours, fluoroscopy was repeated and it showed partial but not complete improvement of valve mobility (Figure 2); in echocardiography, PPG and MPG were 54 mmHg and 38 mmHg.
Third fluoroscopy.. Notes: Twelve hours after second reteplase injection: good and symmetrical opening of the prosthetic pulmonary valve leaflets was observed.
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Fluoroscopy after 12 hours showed good and symmetrical opening of the PPV leaflets (Figure 3).