A case of intermittent, noncyclic prosthetic aortic valve regurgitation

Foukarakis, Emmanouil; Papoutsakis, Antonios; Kafarakis, P; Rogdakis, E; Lazaros, George

doi:10.1016/j.hjc.2019.11.002

Cited by 1 publication

(1 citation statement)

References 8 publications

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“… 1 - 5 It can occur in both mitral and aortic PHVs and may lead to either periodic obstruction or regurgitation of flow, depending on the position of the valve and the phase of the cardiac cycle in which the disc gets trapped. 6 , 7 The most frequently reported causes of intermittent disk dysfunction include pannus formation, entrapment of the disk by thrombi (nonobstructive or obstructive), subvalvular mitral tissue, suture material, vegetations, ventricular myocardium, and arrhythmia. 4 , 5 , 8 , 9 A multimodality approach that includes transthoracic echocardiography (TTE), 2-dimensional (2D) or real-time 3-dimensional (RT-3D) transesophageal echocardiography (TEE), cardiac computed tomography (CT), and fluoroscopy may help the diagnosis of intermittent malfunction of the PHV.…”

Section: Introductionmentioning

confidence: 99%

Lessons Learned From Intermittent Dysfunction of Mechanical Heart Valve

Kalkan¹,

Güner²,

Kalçık³

et al. 2022

The Anatolian Journal of Cardiology

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Background: Intermittent malfunction is a rare but potentially serious complication of prosthetic heart valve replacement. This study aimed to describe the clinical features and etiologic causes of patients with intermittent mechanical prosthetic heart valve dysfunction. Methods: Between 2010 and 2021, 16 patients who were evaluated in the echocardiography laboratory of Koşuyolu Training and Research Hospital with the diagnosis of intermittent malfunction of prosthetic valves were included in the study. Results: The evaluated patients consisted of 12 bi-leaflet mitral valve replacements and 2 mono-leaflet mitral valve replacements. The underlying causes of intermittent malfunction were classified as follows: residual chord (n = 4), obstructive thrombus (n = 2), non-obstructive thrombus (n = 2), vegetation (n = 2), pannus and obstructive thrombus coexistence (n = 1), and solely pannus (n = 1). One of the patients with mono-leaflet mitral valve replacements had pannus and obstructive thrombus. In the other patient with mono-leaflet mitral valve replacement, a stuck valve was observed in 1 of 12 beats secondary to arrhythmia. There were also 2 patients with aortic valve replacements. One patient had moderate aortic regurgitation due to prominent calcification and the other had moderate obstruction due to pannus. In the patient with pannus, a stuck leaflet was observed in 1 of 6 beats and moderate aortic regurgitation arose in 1 of 2 beats in the patient with calcification. Conclusions: The intermittent stuck valve may have catastrophic outcomes. When making a treatment decision in these patients, assessing the degree of regurgitation or stenosis is essential. In particular, the frequency of entrapment should be taken into consideration when deciding the optimal therapy for intermittent prosthetic heart valve dysfunction.

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