BPVT: Echocardiography (long axis)

Typical appearance of BPVT on TEE. In this patient, the aortic prosthetic valve mean gradient increased to 46 mmHg at 2 years after surgical implantation. On long-axis views, there is visible thickening of the body of the prosthetic cusp, with an echo intensity similar to cusp or soft tissues. There is reduced mobility of the leaflets at the affected sites. With warfarin anticoagulation, the mean gradient decreased to 28 mmHg at 1 month and 14 mmHg at 6 months.