Figure legends:
Figure 1 TTE and TEE at presentation; A. Thickened bioprosthetic valve leaflets (yellow arrows) in two perpendicular views by x-plane mode. B. Considerably Increased transvalvular bioprosthetic tricuspid valve gradients (mean gradient: 11 mmHg). C. Significantly increased bioprosthetic tricuspid Valve pressure half time (618 msec). Abbreviations: RA= right atrium, RV= right ventricle
Figure 2 TTE and TEE after thrombolysis A. Thinning of tricuspid bioprosthetic leaflets (yellow arrows) B. decreased transvalvular bioprosthetic tricuspid valve gradients (Mean gradient: 5 mmHg). Abbreviations: RA= right atrium, RV= right ventricle
Figure 3 Three-dimensional reconstruction of bioprosthetic TV valve from the right atrial side views A. Thickening and decreased maximum opening of tricuspid bioprosthetic valve leaflets at presentation (Thick white arrows point to three tricuspid valve leaflets) B. improvement of bioprosthetic tricuspid valve opening and relief of thickening after thrombolysis (Thin white arrows point to three tricuspid valve leaflets).
Supporting information: additional supporting information may be found online in the supporting information section.
Movie S1. Transesophageal echocardiography at presentation in two perpendicular planes. note the considerable thickening and limited motion of bioprosthetic tricuspid valve leaflets.
Movie S2. Transesophageal echocardiography following thrombolysis. Note the thinning of leaflets and improvement of motion.
Movie S3. Three-dimensional reconstruction of bioprosthetic TV valve from the right atrial side views at presentation, thickening of all leaflets with a decreased opening orifice.
Movie S4. Three-dimensional reconstruction of bioprosthetic TV valve from the right atrial side views following thrombolysis, thinning of leaflets with an improved opening orifice.