European Journal of Echocardiography Advance Access first published online on December 13, 2008
This version published online on January 5, 2009
European Journal of Echocardiography, doi:10.1093/ejechocard/jen320
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Intermittent acute aortic regurgitation of a mechanical bileaflet aortic valve prosthesis: diagnosis and clinical implications
1 Department of Cardiology, Hospital del Gobierno de la Ciudad de Buenos Aires ‘Dr. Cosme Argerich’, Pi y Margall 750 (C1155AHB), Buenos Aires, Argentina
2 Researchers of the Secretary of Health, Government of the City of Buenos Aires, Buenos Aires, Argentina
3 Department of Surgery, Laval University, Quebec Biomaterials Institute, St François d'Assise Hospital, CHUQ, Quebec, Canada
Received 1 October 2008; accepted after revision 22 November 2008.
* Corresponding author. Tel: +5411 4801 5510; fax: +5411 4801 4157. E-mail address: tcianciulli{at}fibertel.com.ar, tcianci{at}intramed.net.ar
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Abstract |
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Intermittent aortic regurgitation (AR) is an unusual complication after a mechanical prosthetic replacement. We describe a rare case of intermittent dysfunction of a bileaflet mechanical aortic prosthetic valve in a 41-year-old man with a 21 mm Tri-technologies prosthetic valve implanted 4 years before. Transthoracic echocardiography (TTE) before discharge was normal and prosthesis–patient mismatch was ruled out. He was admitted to our hospital because of mild dyspnoea at effort. TTE revealed acute and severe intermittent AR. The patient underwent surgery, during which abnormal proliferation of subvalvular pannus overgrowth on the inflow aspect of the prosthesis was found impeding the normal closure of one of the discs of the prosthesis. The pannus formation was resected, the Tri-technologies prosthetic valve was prophylactic explanted and a 23 mm St Jude Medical bileaflet mechanical prosthesis valve was implanted. We describe the role of TTE and the limitation of the cinefluoroscopy in the diagnosis of Tri-technologies prosthetic dysfunction.
Keywords: Intermittent aortic regurgitation; Acute prosthetic valve dysfunction; Tri-technologies prosthesis valve; Transthoracic echocardiography; Cinefluoroscopy
The second author affiliation which appeared in the originally published version of this text was not necessary and has been removed. Also, on page 3 line 325 ‘Transthoracic echocardiography’ has been corrected to ‘Transesophageal echocardiography’.