Leaflet escape in an Edwards TEKNA mitral prosthesis

Abstract

In almost every type of artificial valve, structural failure has been described. We are reporting on a case of a sudden leaflet escape of an Edwards TEKNA mitral valve prosthesis 12 years after implantation. The patient had a sudden onset of dyspnea and severe pulmonary edema with subsequent cardiogenic shock. An emergency mitral replacement was successfully performed. A multi-detector computed tomography scanning and three-dimensional imaging showed two fragments that had embolized in the terminal aorta and the left common iliac artery. The patient presented visual field abnormality, and postoperative head computed tomography showed watershed cerebral infarction. The escaped leaflet that fractured transversely was removed, following the patient's recovery, during cardiac surgery.

Causes and treatment strategies of unilateral leaflet escape of bileaflet mechanical prosthetic heart valves after surgery: a case series

“…Nakamura et al reported cases in which the escape leaflets (leaflet rupture) were surgically removed in time, but the author only reported the cases and did not report on the mid-term and long-term follow-up results. Some published researches in the literature recommend removing the escaped leaflet within the short period of replacing the dysfunctional heart valve in stable conditions [16][17][18][19]. Therefore, the advantages and disadvantages of the two treatment schemes can be selected according to a case by case basis, without more evidence-based guidelines.…”