Retrograde strut embolization in a fractured Björk-Shiley mitral prosthesis

Area of Science:

• Cardiovascular Surgery
• Biomedical Engineering
• Cardiac Valve Mechanics

Background:

• The Björk-Shiley convexo-concave mitral valve is a mechanical prosthesis.
• Strut fracture is a rare but serious complication of mechanical heart valves.
• Understanding failure mechanisms is crucial for patient safety.

Observation:

• A case of minor strut fracture in a Björk-Shiley convexo-concave mitral valve is reported.
• The fractured strut embolized retrogradely to a pulmonary vein.
• The strut likely migrated during ventricular systole and became anchored.

Findings:

• The patient underwent successful emergency mitral valve replacement.
• Postoperative computed tomography confirmed the strut's location.
• The embolized strut remained in place for over 1.5 years without further complications.

Implications:

• This case highlights a rare embolic complication of mechanical mitral valve strut fracture.
• Prompt surgical intervention is critical for managing such events.
• Long-term stability of embolized components can occur, as seen in this case.