Key result
A 60-year-old man experienced a fatal leaflet fracture embolization of an Edwards-Duromedics mechanical mitral valve 20 years after implantation, resulting in cardiogenic shock and death despite emergency valve replacement.
Case Report (n=1)
Mechanical valve leaflet fracture embolization is a rare but fatal complication that can occur even 20 years post-implantation, requiring immediate recognition and surgical intervention.
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Alerts clinicians to rare fatal late embolization risk decades post-implantation; leaves open optimal long-term surveillance for legacy mechanical valves.
The fracture embolization of a mechanical valve is a very rare but potentially fatal event that can cause acute severe valve regurgitation and subsequent decompensated heart failure. Generally, the mechanical valve is durable and semi-permanent. If this is not the case, bacterial endocarditis can occur. However, leaflet fracture embolizations related to mechanical failure may occur in the specific mechanical valve brands associated with the subjects own structural fragilities. In this case, we dealt with a case of fatal Edward-Duromedics mechanical mitral valve leaflet fracture embolization that had been implanted 20 years ago. The patient presented with severe acute heart failure and shock. Severe transvalvular mitral regurgitation and only one valve leaflet was observed in echocardiography. Although the emergency mitral valve replacement was performed under the diagnosis with valve leaflet fracture embolization, the patient was not resuscitated from systolic pump failure and died.
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Lee et al. (2011) conducted a case report in Mechanical mitral valve leaflet fracture embolization (n=1). Edwards-Duromedics mechanical mitral valve was evaluated on Clinical outcome (mortality). A 60-year-old man experienced a fatal leaflet fracture embolization of an Edwards-Duromedics mechanical mitral valve 20 years after implantation, resulting in cardiogenic shock and death despite emergency valve replacement.
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