Intraoperative acute type A dissection caused by an intra-aortic filter (EMBOL-X) in a patient undergoing mitral valve re-replacement for acute endocarditis.
We report on the case of a 60-year-old male patient who underwent mitral valve re-replacement for acute mechanical valve endocarditis. When an intra-aortic filter (EMBOL-X Inc, Mountain View, CA) was inserted through the arterial cannula in order to prevent embolization from a floating thrombus attached to the mitral valve prosthesis, our patient developed acute type A aortic dissection. This, to our knowledge, is the first report on this kind of complication using intra-aortic filter systems. Here we discuss a potential mechanism that might have led to the event of acute type A dissection in our case. Furthermore we point out strategies that might help to prevent this life-threatening complication in the future.
Leyh
Rainer G
RG
Division of Thoracic and Cardiovascular Surgery, Hanover Medical School, Carl Neuberg St. 1, 30623 Hanover, Germany. leyh@thg.mh-hannover.de
Fischer
Stefan
S
Harringer
Wolfgang
W
Haverich
Axel
A
D000784:Aortic Dissection / Q000209:etiology*; D001014:Aortic Aneurysm / Q000209:etiology*; D006328:Cardiac Catheterization / Q000295:instrumentation*; D004697:Endocarditis, Bacterial / Q000382:microbiology / Q000601:surgery; D013293:Enterococcus faecalis; D016908:Gram-Positive Bacterial Infections / Q000209:etiology; D006350:Heart Valve Prosthesis / Q000009:adverse effects; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000382:microbiology / Q000601:surgery