title: Late leaflet fracture and embolization of a Duromedics mitral prosthesis.
abstract: A case of leaflet fracture and embolization of a mitral prosthetic valve is described. A 54-year-old man had received mitral valve replacement with an Edwards-Duromedics 29M prosthetic valve, at 10 years ago. Emergency mitral valve replacement was performed because the patient had severe congestive left heart failure with severe acute mitral regurgitation caused by a fracture in one of the mitral valve leaflets. The leaflet, which was fractured into 2 pieces, was removed from the right common iliac artery at 3 months after valve replacement. Visual inspection revealed that the leaflet contained a midline fracture. The fracture originated within a cavitary erosion pit near the major radius of the leaflet. The patient recovered from acute renal failure, requiring hemodialysis for 80 days, and is currently without complaints. We have used a Duromedics mitral valve in 11 patients, from April 1987 to April 1988. No subsequent valve failure has occurred. The diagnosis, treatment and cause of a mechanical valve fracture are discussed.
authors.affiliation: Department of Cardiovascular Surgery, Kyorin University, Tokyo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Sudo
authors.forename: N
authors.initials: N
authors.lastname: Sasagawa
authors.forename: H
authors.initials: H
authors.lastname: Ide
authors.forename: M
authors.initials: M
authors.lastname: Nunokawa
authors.forename: T
authors.initials: T
authors.lastname: Fujiki
authors.forename: K
authors.initials: K
authors.lastname: Tonari
mesh_terms: D004617:Embolism / Q000209:etiology; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve; D008944:Mitral Valve Insufficiency / Q000209:etiology; D011475:Prosthesis Failure; D012086:Reoperation