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Updated: May 24, 2026
12:17
Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
Episodic circulatory collapse caused by intermittent prosthetic aortic valve dysfunction
Thirumaran Rajathurai1, Ganesh Nallur Shivu, Richard Wheeler
1Department of Cardiology, University Hospital of Wales, Cardiff, UK.
The Heart Surgery Forum
|February 25, 2012
Summary
A rare case of mechanical aortic valve dysfunction caused by pannus and thrombus led to intermittent circulatory collapse. Early diagnosis requires careful auscultation and prolonged echocardiography to detect episodic valve sticking.
Area of Science:
- Cardiology
- Biomedical Engineering
Background:
- Mechanical aortic valve prostheses are crucial for treating aortic valve disease.
- Medtronic Hall (tilting-disc) prostheses are designed for durability and function.
- Pannus and thrombus formation can compromise valve function.
Observation:
- An 80-year-old woman experienced recurrent episodes of chest pain and circulatory collapse.
- Initial diagnostic workup, including computed tomography angiography and transthoracic echocardiography, was inconclusive.
- Intermittent absence of the prosthetic second heart sound was noted on auscultation.
Findings:
- Transesophageal echocardiography revealed intermittent sticking of the aortic valve in the open position.
- Surgical valve replacement identified significant pannus and thrombus formation on the prosthesis.
- These findings are rare for this type of mechanical valve.
Implications:
- Intermittent mechanical valve dysfunction can be challenging to diagnose.
- Regular, thorough auscultation and echocardiography are vital for assessing prosthetic valve function.
- Prolonged echocardiographic monitoring with Doppler or M-mode at slow sweep speeds can aid in diagnosing episodic valve dysfunction.
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