Intermittently stuck occluder: case report of an unusual complication with the use of an aortic Omniscience prosthesis.

An occluder which intermittently became stuck in the open position with concomitant aortic regurgitation was encountered in a patient subjected to an aortic valve replacement with a 23 Omniscience prosthetic valve. The patient was intermittently aware of the complete momentary disappearances of the valve sounds, the etiology of which could not be discerned. During fluoroscopic examination, the occluder became stuck for a few cardiac cycles in what appeared to be the fully open position before finally moving. Prosthetic valve malfunction was thus diagnosed. The emergency operation was successful. Operative findings revealed that a thin thrombus had developed in a curtain-like fashion on the left ventricular face of the prosthesis with mild tissue overgrowth along the perimeter of the valve. The Omniscience prosthesis was replaced with a 19-mm St. Jude Medical prosthesis, and the patient's postoperative course has been uneventful.