Fracture embolization of a Tekna mitral prosthesis: case report

Area of Science:

• Cardiovascular Surgery
• Biomaterials Science
• Medical Device Engineering

Background:

• The Duromedics-Tekna bileaflet pyrolitic carbon mechanical prosthesis, reintroduced by Baxter in 1990, is a type of prosthetic heart valve.
• Mechanical heart valves are crucial for treating severe valvular heart disease, requiring long-term durability and biocompatibility.

Observation:

• This report documents the first observed instance of sudden leaflet fracture in a Tekna mitral valve.
• The fracture occurred five years after the initial implantation of the mechanical heart valve.

Findings:

• The fractured leaflets embolized to the aortic bifurcation and left common femoral artery.
• Computed tomography (CT) was used to precisely locate the embolized fragments.
• The patient underwent successful valve replacement with a St. Jude Medical mechanical prosthesis, and the fragments were removed.

Implications:

• This case highlights a potential failure mode in the Tekna mechanical heart valve, emphasizing the need for vigilance in long-term patient monitoring.
• The successful management underscores the importance of prompt diagnosis and surgical intervention in cases of prosthetic valve failure.
• Findings may inform future design improvements and material selection for mechanical heart valves to enhance durability and patient safety.