Leaflet fracture and embolization from an On-X mechanical mitral valve

Commentary: How can you mend a broken heart: Mechanical valve leaflet fracture

“…With this case report, Helgeland 1 has brought to light an extremely, rare but important, complication of modern A rapid and accurate diagnosis, along with appropriate management, offers the best chance for optimal patient outcomes in mechanical prosthetic valve leaflet fracture.…”

“…Helgeland 1 has reported the fourth known case of On-X mechanical valve leaflet fracture with embolization and only the second patient to have survived this complication. Acute massive prosthetic mitral valve regurgitation carries high mortality, and Helgeland 1 should first be commended on their successful treatment of this patient.…”

“…Helgeland 1 has reported the fourth known case of On-X mechanical valve leaflet fracture with embolization and only the second patient to have survived this complication. Acute massive prosthetic mitral valve regurgitation carries high mortality, and Helgeland 1 should first be commended on their successful treatment of this patient. 2 Although older mechanical valves had a greater propensity of valve fracture and embolization, newer generation models can also be at risk for this complication, as seen by this report and others.…”

“…Helgeland 1 appropriately highlighted that rapid diagnosis and treatment are critical to patient survival in the setting of leaflet fracture. As outlined in the report, the imaging modalities essential for the diagnosis of leaflet fracture include transesophageal echocardiography and non–contrast-enhanced computed tomography.…”

“… 4 , 8 The distal location of an embolus and patient symptoms, including signs of malperfusion, should be used as clinical guides to determine the urgency of retrieval. In this case, Helgeland 1 wisely chose to first address the patient's hemodynamic compromise with redo-mitral valve replacement before performing further diagnostic studies, followed by retrieval of the embolized piece during a second operation.…”