Evaluation of a bileaflet aortic valve prosthesis before and after thrombolytic tissue plasminogen activator therapy by continuous wave Doppler ultrasound

Thrombotic obstruction of mechanical prosthetic valves is a frequently encountered cause of prosthetic valve dysfunction, which can result in stenosis and regurgitation. We present a case of thrombotic obstruction of a bileaflet mechanical aortic valve prosthesis that resulted in severe stenosis and regurgitation. Considering the known risk factors associated with both surgical and thrombolytic treatments, a decision was made to use tissue plasminogen activator therapy to relieve the burden of the thrombotic valvular obstruction. In this case review, we use continuous wave Doppler to demonstrate recovery of normal valve function despite suboptimal two-dimensional imaging.