Key result
Emergency prosthetic valve replacement and embolized leaflet removal rescues a patient with cardiogenic shock.
Why the study?
Leaflet escape of prosthetic mitral valves is a rare but potentially life-threatening complication requiring timely diagnosis and emergent surgical correction.
Case Report (n=1)
No
Prosthetic valve leaflet escape is a rare, life-threatening complication requiring prompt multimodality imaging diagnosis and emergent surgical intervention.
Alerts clinicians to rare late leaflet escape in mechanical mitral valves; extends sparse literature on very long-term durability failures.
Leaflet escape of prosthetic valve is rare but potentially life threatening. It is essential to make timely diagnosis in order to avoid mortality. Transesophageal echocardiography and cinefluoroscopy is usually diagnostic and the location of the missing leaflet can be identified by computed tomography (CT). Emergent surgical correction is mandatory. We report a case of fractured escape of Edward-Duromedics mitral valve 27 years after the surgery. The patient presented with symptoms of acute decompensated heart failure and cardiogenic shock. She was instantly intubated and mechanically ventilated. After prompt evaluation including transthoracic echocardiography and CT, the escape of the leaflet was confirmed. The patient underwent emergent surgery for replacement of the damaged prosthetic valves immediately. Eleven days after the surgery, the dislodged leaflet in iliac artery was removed safely and the patient recovered well.
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Kim et al. (2013) conducted a case report in Prosthetic mitral valve leaflet escape (n=1). Emergency surgical replacement of prosthetic mitral valve was evaluated on Patient survival and recovery. Emergency surgical replacement of the damaged prosthetic valve and subsequent removal of the embolized leaflet resulted in successful recovery of a patient presenting with cardiogenic shock.
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