Kim Tae Yeon, Kim Myoung Young
Department of Thoracic and Cardiovascular Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
J Chest Surg. 2021 Oct 5;54(5):419-421. doi: 10.5090/jcs.20.050.
Fracture of prosthetic valve leaflets in the absence of traumatic injury is very rare. Leaflet fracture can cause acute pulmonary edema and cardiogenic shock and is potentially life-threatening, requiring emergency surgery. Thus, a leaflet fracture must be diagnosed quickly and accurately. We present the case of a 46-year-old man with CarboMedics prosthetic aortic and mitral valve replacements implanted 24 years previously. The patient presented at our emergency department with abrupt dyspnea and fever. We diagnosed severe mitral valve regurgitation with anterior leaflet fracture. The patient underwent venoarterial extracorporeal membrane oxygenation and delayed mitral valve replacement. The foreign body was removed step by step because the diagnosis was missed. Two pieces of broken leaflets were found in the left common iliac artery and left external iliac artery. The patient was treated successfully and remains asymptomatic 1 year following surgery.
在无创伤性损伤的情况下，人工瓣膜小叶骨折非常罕见。小叶骨折可导致急性肺水肿和心源性休克，有潜在生命危险，需要紧急手术。因此，必须快速准确地诊断小叶骨折。我们报告一例46岁男性病例，其24年前植入了CarboMedics人工主动脉瓣和二尖瓣。该患者因突发呼吸困难和发热就诊于我院急诊科。我们诊断为严重二尖瓣反流伴前叶骨折。患者接受了静脉-动脉体外膜肺氧合及延迟二尖瓣置换术。由于漏诊，异物被逐步取出。在左髂总动脉和左髂外动脉中发现了两片破碎的小叶。患者治疗成功，术后1年无症状。
