Mert Murat, Ozkara Ahmet, Hatemi AliCan
Istanbul University, Institute of Cardiology, Department of Cardiovascular Surgery, Istanbul, Turkey.
J Heart Valve Dis. 2003 Jul;12(4):513-5.
The original Duromedics-Edwards bileaflet valve was withdrawn from the market in 1988 after 12 reports of leaflet escape. The leaflet was modified by the manufacturer, and the revised Edwards-Duromedics and Edwards TEKNA valves were introduced in 1990 and 1993, respectively. However, problems of leaflet escape have now been reported with the new models. A case is reported of sudden leaflet fracture of a revised Duromedics mitral valve 86 months after implantation; this was managed successfully by emergency replacement with a St. Jude Medical mechanical prosthesis. The fracture had occurred transversely, with the two fragments embolizing bilaterally to the right common iliac and left external iliac arteries. In the absence of an exact diagnosis, but with a high index of suspicion, the key to survival of patients with leaflet escape is immediate reoperation.
最初的杜罗梅迪克斯-爱德华兹双叶瓣瓣膜在出现12例瓣叶脱出报告后于1988年退出市场。制造商对瓣叶进行了改进，分别于1990年和1993年推出了改良后的爱德华兹-杜罗梅迪克斯瓣膜和爱德华兹TEKNA瓣膜。然而，现在已有新型号出现瓣叶脱出问题的报告。本文报告了1例植入改良杜罗梅迪克斯二尖瓣86个月后瓣叶突然断裂的病例；通过紧急更换圣犹达医疗机械瓣膜成功处理了该病例。断裂呈横向发生，两块碎片分别栓塞至双侧右髂总动脉和左髂外动脉。在没有确切诊断但高度怀疑的情况下，瓣叶脱出患者生存的关键是立即再次手术。
