title: Fracture embolization of a Duromedics mitral prosthesis.
abstract: The Duromedics bileaflet pyrolitic carbon mechanical prosthesis was introduced by Hemex in 1982 and subsequently acquired by Baxter. This communication documents a case of sudden leaflet fracture of a Duromedics mitral valve 48 months after implantation, which was managed successfully by replacement with a St. Jude Medical mechanical prosthesis. The patient presented in acute distress with paroxysmal atrial tachycardia and pulmonary edema. Transesophageal echocardiography was used to diagnose the leaflet fracture. The fracture had occurred transversely, with the fragments embolizing bilaterally to the iliofemoral arteries. These were removed at a subsequent operation. Cases of such fractures of the Duromedics prosthesis have been reported, with cavitation damage being the postulated mechanism.
authors.affiliation: Division of Cardiovascular and Thoracic Surgery, Vancouver General Hospital, University of British Columbia, Canada.
authors.forename: F J
authors.initials: FJ
authors.lastname: Baumgartner
authors.forename: A I
authors.initials: AI
authors.lastname: Munro
authors.forename: W R
authors.initials: WR
authors.lastname: Jamieson
mesh_terms: D000208:Acute Disease; D000328:Adult; D017548:Echocardiography, Transesophageal; D004868:Equipment Failure; D005548:Foreign-Body Migration / Q000209:etiology*; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D008943:Mitral Valve; D011654:Pulmonary Edema / Q000000981:diagnostic imaging / Q000209:etiology*; D013612:Tachycardia, Ectopic Atrial / Q000000981:diagnostic imaging / Q000209:etiology*; D013614:Tachycardia, Paroxysmal / Q000000981:diagnostic imaging / Q000209:etiology*