Hjelms E
Thorac Cardiovasc Surg. 1983 Oct;31(5):310-2. doi: 10.1055/s-2007-1022004.
Twenty-three months after mitral valve replacement for mitral stenosis with a St. Jude Medical heart valve prosthesis size 31, a 29-year-old man suddenly went into a profound cardiogenic shock and pulmonary edema due to escape of one of the leaflets from the prosthesis. At emergency operation the valve was replaced with another type of prosthesis. The escaped leaflet was retrieved from the abdominal aorta and was found to be intact. The cause of the escape was found to be a fracture in the pivot area. Further examination with optic and scanning electron microscopy revealed an old fracture at the base of the pivot covered with organic material and another fracture at the top of the pivot area not covered with organic material and therefore probably very recent and responsible for the break-off of part of the area and subsequent escape of the leaflet. The cause of the primary fracture is unknown.
一名29岁男性在使用圣犹达医疗公司31号心脏瓣膜假体进行二尖瓣狭窄二尖瓣置换术后23个月，因假体的一个瓣叶脱出，突然陷入严重的心源性休克和肺水肿。在急诊手术中，该瓣膜被更换为另一种类型的假体。脱出的瓣叶从腹主动脉中取出，发现其完好无损。脱出的原因是枢轴区域发生骨折。通过光学显微镜和扫描电子显微镜进一步检查发现，枢轴底部有一处陈旧性骨折，表面覆盖有有机物质，枢轴区域顶部有另一处骨折，未覆盖有机物质，因此可能是非常近期发生的，导致该区域部分断裂，随后瓣叶脱出。原发性骨折的原因不明。
