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You are here: Contents > 2006 > Volume 15 Number 1 January 2006 > DEVICE EVALUATION > Fatal Leaflet Escape in an Edwards TEKNA Aortic Prosthesis

Fatal Leaflet Escape in an Edwards TEKNA Aortic Prosthesis

Heidi Pfeiffer, Julia Bertolini, Hans Heinrich Scheld, Bernd Brinkmann

Institute of Legal Medicine, Münster, Institute of Pathology, Leipzig, Department of Cardiovascular and Thoracic Surgery, University Hospital, Münster, Germany

The case is reported of a 26-year-old male patient who died eight years after the replacement of an aortic valve with a bileaflet mechanical valve (TEKNA®; Edwards, USA). Following prosthesis implantation, the patient had been in a good state of health, and his death occurred unexpectedly. Forensic autopsy revealed a leaflet escape, with two fragments of the leaflet being found bilaterally in the common iliac arteries. Death occurred due to an acute cardiac insufficiency. Immunohistochemical

investigations revealed fresh myocardial fiber necroses. Stereomicroscopic and scanning electron microscopic investigations demonstrated surface erosions of the leaflet. Although the valve was withdrawn from the market in June 2000, it had previously been implanted in over 18,000 patients. Thus, from a clinical viewpoint, the question of using a prophylactic replacement in affected patients must be discussed.
The Journal of Heart Valve Disease 2006;15:97-99

Fatal Leaflet Escape in an Edwards TEKNA Aortic Prosthesis

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