Cor Vasa 2004, 45(5):233-235
A rare case of mechanical prosthesis failure
- Kardiochirurgické oddelenie, Nemocnica České Budějovice, České Budějovice, Česká republika
The authors describe the clinical case of a 52-year-old patient with grade III aortic regurgitation and ascending aorta dilation, scheduled for operative correction following infectious focus eradication. Thirty minutes after an uneventful procedure-valve and ascending aorta replacement with a combined prosthesis (a mechanical prosthesis sutured to a vascular prosthesis)-the patient suddenly developed circulatory collapse, electromechanical dissociation and ventricular fibrillation, requiring cardiopulmonary resuscitation. Dysfunction of mechanical prosthesis leaflets, covered by a fibrin film, was documented during re-do surgery. Histology revealed infectious endocarditis while polymerase chain reaction demonstrated the presence of Staphylococcus species. After a complicated postoperative course the patient, despite significant left ventricular dysfunction, is alive and in a generally good condition. Structural dysfunction of the valve per se, valve thrombosis as a result of intraoperative administration of aprotinin or biological glue, or thrombosis due to bacteremia, turbulent flow, and procoagulation status of the patient have all been incriminated as possible causes of mechanical valve dysfunction.
Keywords: Valve prosthesis dysfunction; Infectious endocarditis; Thrombosis
Published: May 1, 2004 Show citation