Embolized mechanical aortic valve leaflet causing infrarenal aortic stenosis and claudication.

Area of Science:

• Cardiovascular Surgery
• Biomedical Engineering
• Cardiology

Background:

• Leaflet escape from mechanical heart valves is a rare but potentially fatal complication.
• Embolized leaflets can lead to infection, thrombosis, and migration if not retrieved.
• Prompt retrieval of escaped leaflets is crucial to prevent further complications.

Observation:

• A case is presented where a mechanical aortic valve leaflet embolized during reoperation.
• The escaped leaflet was not retrieved initially.
• Occlusive aortic disease was diagnosed 2 years later, attributed to the embolized leaflet.

Findings:

• Embolized mechanical heart valve leaflets can lead to significant vascular complications.
• Delayed diagnosis of leaflet fragments can result in severe sequelae, such as occlusive aortic disease.
• The case highlights the long-term risks associated with unretrieved leaflet fragments.

Implications:

• This case underscores the critical importance of thoroughly locating and retrieving any missing mechanical heart valve leaflets.
• Surgeons must be vigilant for leaflet fragments during prosthetic valve replacement and reoperation procedures.
• Improved diagnostic and retrieval strategies may be necessary to manage this rare but severe complication.