Mitral valve replacement, hence thrombosis of prosthetic heart valves (PHV) are not uncommon in our country. The diagnosis is commonly established by increased gradients across PHV during transthoracic echo and restricted leaflet movement during transesophageal echo or fluoroscopy. We demonstrated the leaflets of a bileaflet PHV, of which one was stuck in closed position and the movement of the other was partially restricted by real-time three-dimensional transesophageal echocardiography.
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