title: Intermittent electromechanical dissociation due to mechanical prosthetic valve dysfunction.
abstract: We describe a patient who developed the rare hemodynamic phenomenon of intermittent electromechanical dissociation during normal sinus rhythm at about four months after mitral valve replacement with a Medtronic Hall prosthesis, along with resuspension of the papillary muscles using Gore-Tex sutures. Echocardiographic examination confirmed the presence of a filamentous structure that could be either suture material, tissue tag or thrombus, and was entangling intermittently in the prosthesis. The patient recovered spontaneously after a three-week symptomatic period, with no subsequent evidence of either electromechanical dissociation or the filamentous structure; normal prosthetic valve function was restored. During a subsequent three-month follow up period, the patient was asymptomatic, with normal prosthetic valve function. The diagnostic and hemodynamic aspects of this case are discussed.
authors.affiliation: Department of Cardiology, Sanjay Gandhi PGIMS, Lucknow, India.
authors.forename: N K
authors.initials: NK
authors.lastname: Garg
authors.forename: A
authors.initials: A
authors.lastname: Kapoor
authors.forename: N
authors.initials: N
authors.lastname: Sinha
mesh_terms: D000328:Adult; D004452:Echocardiography; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008943:Mitral Valve; D008946:Mitral Valve Stenosis / Q000601:surgery; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology*; D011475:Prosthesis Failure; D012214:Rheumatic Heart Disease / Q000601:surgery; D013537:Sutures; D013575:Syncope / Q000209:etiology*; D013927:Thrombosis / Q000000981:diagnostic imaging