Management of prosthetic valve thrombosis concomitant with coronary embolism

Abstract

complementary method to TEE in the evaluation of PVT and guiding TT (4, 7). Real-time three-dimensional (RT-3D) TEE has emerged as an important clinical tool in the assessment of PVT for more than 10 years. RT-3D TEE has higher spatial resolution, resulting in images with unparalleled anatomical detail when compared with two-dimensional (2D) imaging. The detection of non-obstructive PVT can be challenging, particularly when Doppler parameters are within normal limits, and clinical findings are subtle. Hence, non-obstructive PVT can be even missed with 2D TEE. The diagnostic accuracy for detecting PVT was improved after the introduction of RT-3D TEE, especially for those on mitral position (7). In conclusion, low-dose and slow infusion TT would be a better treatment strategy in such patients with concomitant CE and PVT except cardiogenic shock.