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Leaflet escape in a revised Edwards-Duromedics mitral prosthesis
Murat Mert1, Ahmet Ozkara, AliCan Hatemi
1Istanbul University, Institute of Cardiology, Department of Cardiovascular Surgery, Istanbul, Turkey.
The Journal of Heart Valve Disease
|August 16, 2003
Summary
Bileaflet valve leaflet escape, a known issue, has recurred in newer models. A case of mitral valve leaflet fracture highlights the critical need for prompt reoperation in patients experiencing this dangerous mechanical failure.
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
- Materials Science
Background:
- The Duromedics-Edwards bileaflet valve was recalled due to leaflet escape.
- Revised models (Edwards-Duromedics, Edwards TEKNA) were introduced but also show this defect.
Observation:
- A revised Duromedics mitral valve fractured 86 months post-implantation.
- The fracture was transverse, causing bilateral embolization to iliac arteries.
Findings:
- The patient underwent emergency replacement with a St. Jude Medical mechanical prosthesis.
- Successful management was achieved through immediate reoperation.
Implications:
- Leaflet escape remains a significant concern in bileaflet mechanical valves.
- Prompt surgical intervention is crucial for patient survival in cases of leaflet escape or fracture.