Renal failure after embolization of a prosthetic mitral valve disc and review of systemic disc embolization

Embolization of discs from various prosthetic mitral valves produces fulminant cardiac failure with possible survival after emergent mitral valve prosthetic replacement. The embolized discs lodge in the aorta at various levels parallel to the blood stream and have not occluded distal flow. Some embolized discs have been left in the aorta for as long as 12 years. An embolized disc left in the abdominal aorta produced renal artery occlusion 5 years after embolization in the reported case. A previous case produced mesenteric ischemia after 1 month. Localization of embolized discs has at times been difficult with success and failure by plain x-ray films, ultrasound, angiography, and CT scans in some cases. Since embolized discs have not produced acute problems with ischemia, delay of retrieval after emergent mitral valve replacement does not seen detrimental. Late complications may occur as with the present case and removal of asymptomatic embolized discs seems advisable and prudent.