title: Leaflet escape of a mitral Duromedics prosthesis. Case report.
abstract: This article reports a case of leaflet embolization of a mitral Edwards-Duromedics prosthesis. The patient had abrupt onset of acute pulmonary edema and was initially treated medically for 3 days. Fluoroscopy showed only one freely moving leaflet and the other was (incorrectly) assumed to be blocked in the closed position. The patient received IV thrombolysis for another 3 days and was finally operated. He died 8 days later from sepsis and the leaflet was recovered at autopsy in the abdominal aorta. Leaflet escape of a mitral Edwards-Duromedics prosthesis is a rare, potentially curable mode of valve failure. Correct interpretation of clinical signs and symptoms and of fluoroscopy should allow early diagnosis and surgical therapy.
authors.affiliation: Service of Cardiac Surgery, Hôpital Universitaire Brugmann, ULB, Brussels, Belgium.
authors.forename: F E
authors.initials: FE
authors.lastname: Deuvaert
authors.forename: J
authors.initials: J
authors.lastname: Devriendt
authors.forename: J
authors.initials: J
authors.lastname: Massaut
authors.forename: G
authors.initials: G
authors.lastname: Van Nooten
authors.forename: J
authors.initials: J
authors.lastname: De Paepe
authors.forename: G
authors.initials: G
authors.lastname: Primo
mesh_terms: D004617:Embolism / Q000150:complications; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D011475:Prosthesis Failure; D012086:Reoperation