Multidisciplinary Teamwork in Management of Dislodged Prosthetic Aortic Valve Leaflet

Abstract

Mechanical valve leaflets have the potential to detach and migrate to unintended locations, leading to life- and limb-threatening situations. We report a unique case of a dislodged mechanical aortic valve leaflet in the right iliac artery bifurcation after a redo mitral valve replacement. This was promptly recognized by input from a multidisciplinary team, allowing immediate correction of the aortic valve insufficiency followed by staged retrieval of the dislodged leaflet to avoid vascular complications. This case highlights the importance of a multidisciplinary team in decision-making and timely intervention. Further research is needed for better understanding of risk factors and prevention strategies.

Figure 1

(A) Axial and (B) coronal helical cardiac computed tomography images illustrate absence of the left mechanical valve leaflet.

Figure 2

Computed tomography angiography (A) axial and (B) coronal views of the pelvis demonstrate a linear metallic density in the right common iliac artery (arrow) compatible with a missing aortic valve leaflet.

Figure 3

(A) Surgical view and (B) extracted mechanical aortic valve leaflet.