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Fatal leaflet escape in an Edwards TEKNA aortic prosthesis
Heidi Pfeiffer1, Julia Bertolini, Hans Heinrich Scheld
1Institute of Legal Medicine, University Hospital Münster, Münster, Germany. pfeiffh@uni-muenster.de
The Journal of Heart Valve Disease
|February 17, 2006
Summary
A patient died from acute cardiac insufficiency due to mechanical aortic valve failure. Fragments of the TEKNA valve leaflet were found in the iliac arteries, indicating a rare but serious complication.
Area of Science:
- Cardiovascular Surgery
- Biomaterials Science
- Forensic Pathology
Background:
- A 26-year-old male received a TEKNA bileaflet mechanical aortic valve prosthesis.
- The patient experienced good health for eight years post-implantation.
Observation:
- The patient died unexpectedly from acute cardiac insufficiency.
- Forensic autopsy revealed leaflet escape; fragments were found in the common iliac arteries.
- Microscopic examination showed surface erosions on the retrieved valve leaflet.
Findings:
- The cause of death was acute cardiac insufficiency.
- Immunohistochemistry confirmed fresh myocardial fiber necrosis.
- Stereomicroscopic and scanning electron microscopy revealed leaflet surface erosions.
Implications:
- The TEKNA valve was withdrawn from the market in June 2000.
- Over 18,000 patients received this valve prosthesis.
- The findings necessitate a discussion regarding prophylactic replacement in patients with this valve.
