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Optimal imaging techniques for locating leaflets after escape from prosthetic heart valves
B C Tsui1, C E Kinley, R M Miller
1Faculty of Medicine, Dalhousie University, Halifax, NS.
Summary
Leaflets from bileaflet prosthetic heart valves can escape. Early computed tomography (CT) is crucial for locating escaped leaflets, especially when extrusion through the arterial wall is suspected.
Area of Science:
- Cardiovascular Surgery
- Medical Imaging
- Biomedical Engineering
Background:
- Bileaflet prosthetic heart valves are used to replace damaged heart valves.
- Valve leaflet failure can lead to serious complications.
- Prompt diagnosis and management are critical for patient outcomes.
Observation:
- Two cases of leaflet escape from an Edwards-Duromedics bileaflet prosthetic heart valve are reported.
- Various imaging modalities were employed to detect the escaped leaflets.
- Computed tomography (CT) provided conclusive results in identifying leaflet location.
Findings:
- Escaped leaflets were surgically confirmed to be extruding through the arterial wall.
- CT imaging successfully visualized the extruded leaflets.
- Extrusion through the arterial wall prevents intravascular retrieval methods.
Implications:
- Early CT imaging is recommended immediately following suspected leaflet escape, even in asymptomatic individuals.
- Arterial wall extrusion necessitates specific management strategies, as percutaneous retrieval becomes impossible.
- This highlights the importance of advanced imaging in managing prosthetic heart valve complications.