# Differentiating Mobile Masses on Transcatheter Aortic Valve: Thrombi or Vegetations?

## TL;DR

This case study discusses the challenge of distinguishing between a heart valve clot and infection in a patient who had a valve replacement.

## Contribution

The paper presents a clinical case emphasizing diagnostic challenges in prosthetic valve complications.

## Key findings

- The patient showed increased transvalvular gradients and suspected prosthetic thrombosis.
- Blood cultures revealed Streptococcus sanguinis, suggesting infective endocarditis.
- The case illustrates difficulties in differentiating thrombi from vegetations on prosthetic valves.

## Abstract

A 58-year-old female presented with new-onset dyspnea. Two years prior, she had undergone a transcatheter aortic valve replacement with a 26-mm Edwards Sapien 3 valve. Diagnostic testing included transthoracic and transesophageal echocardiograms that revealed increased transvalvular gradients and suspected prosthetic thrombosis. Laboratory testing included blood cultures that unexpectedly grew Streptococcus sanguinis. This case highlights the difficulty in differentiating prosthetic valve thrombosis from infective endocarditis and the possible therapeutic complications that could arise.