Leaflet Fracture and Embolization of a CarboMedics Prosthetic Mitral Valve: Case Report

• Published in: Journal of chest surgery Vol. 54; no. 5; pp. 419 - 421
• Main Authors: Kim, Tae Yeon, Kim, Myoung Young
• Format: Journal Article
• Language: English
• Published: The Korean Society for Thoracic and Cardiovascular Surgery 05.10.2021; Korean Society for Thoracic & Cardiovascular Surgery; 대한흉부외과학회
• Subjects: cardiogenic shock; Case Report; leaflet fracture; mitral valve replacement; 흉부외과학
• ISSN: 2765-1606; 2765-1614; 2765-1614
• DOI: 10.5090/jcs.20.050

Fracture of prosthetic valve leaflets in the absence of traumatic injury is very rare. Leaflet fracture can cause acute pulmonary edema and cardiogenic shock and is potentially life-threatening, requiring emergency surgery. Thus, a leaflet fracture must be diagnosed quickly and accurately. We present the case of a 46-year-old man with CarboMedics prosthetic aortic and mitral valve replacements implanted 24 years previously. The patient presented at our emergency department with abrupt dyspnea and fever. We diagnosed severe mitral valve regurgitation with anterior leaflet fracture. The patient underwent venoarterial extracorporeal membrane oxygenation and delayed mitral valve replacement. The foreign body was removed step by step because the diagnosis was missed. Two pieces of broken leaflets were found in the left common iliac artery and left external iliac artery. The patient was treated successfully and remains asymptomatic 1 year following surgery.Fracture of prosthetic valve leaflets in the absence of traumatic injury is very rare. Leaflet fracture can cause acute pulmonary edema and cardiogenic shock and is potentially life-threatening, requiring emergency surgery. Thus, a leaflet fracture must be diagnosed quickly and accurately. We present the case of a 46-year-old man with CarboMedics prosthetic aortic and mitral valve replacements implanted 24 years previously. The patient presented at our emergency department with abrupt dyspnea and fever. We diagnosed severe mitral valve regurgitation with anterior leaflet fracture. The patient underwent venoarterial extracorporeal membrane oxygenation and delayed mitral valve replacement. The foreign body was removed step by step because the diagnosis was missed. Two pieces of broken leaflets were found in the left common iliac artery and left external iliac artery. The patient was treated successfully and remains asymptomatic 1 year following surgery.