Long-term event-free survival with an embolised prosthetic valve leaflet in the thoracic aorta.
We report the case of a patient who underwent a redo surgery for a leaflet escape from a Bjork-Shiley tilting disc mitral prosthesis inserted 18 years previously. The escaped disc remained lodged in the thoracic aorta without any complication. She ultimately died of terminal heart failure 13 years after the second operation. We believe this to be the longest survival with a dislodged leaflet from a mechanical valve. Removal of dislodged disc is recommended in literature but there may be a place for watchful observation in exceptional cases with no haemodynamic compromise.
Department of Cardiothoracic Surgery, South Manchester University Hospital, Manchester, UK. mohandev@hotmail.com
Mohan P
MP
Devbhandari
Edwin B C
EB
Woo
Timothy L
TL
Hooper
D001013:Aorta, Thoracic; D003937:Diagnosis, Differential; D018572:Disease-Free Survival; D017548:Echocardiography, Transesophageal; D004617:Embolism / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D017809:Fatal Outcome; D005260:Female; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000601:surgery*; D011475:Prosthesis Failure; D012086:Reoperation; D013997:Time Factors