Вальсальва

Latest AHA/ACC focused update guideline Several studies showed the usefulness of the multimodality of images in the assessment of patients with suspected PVT. It is well-established the use of the echocardiography and fluoroscopy in the diagnosis of the PVT. Recently, the use of CT tomography and 3D real-time transesophageal echocardiography has been incorporated as diagnostic tools in the PVT. Those tools have been useful not only in the diagnostic evaluation but also in the follow-up of the thrombolytic therapy. The AHA/ACC Guideline recommends that the urgent evaluation with multimodality imaging be used in the mechanical PVT diagnosis and follow-up of patients with suspected mechanical prosthetic valve thrombosis. The urgent evaluation with multimodality imaging is used to assess valvular function, leaflet motion, and the presence and editorial size of thrombus (Recommendation Class I-B).

Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Fleisher LA, et al. 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2017; 135: 1159-1195.