The Annals of Thoracic Surgery, Vol 20, 256-264, Copyright © 1975 by The Society of Thoracic Surgeons
Occluder disruption of Wada-Cutter valve prosthesis
BB Roe, NH Fishman, JC Hutchinson and SH Goodenough
Total detachment and embolization of the hinged, tilting occluder of the
Wada-Cutter prosthetic heart valve was the proved cause of death in 2 of 25
patients who had these devices implanted at the University of California,
San Francisco, Medical Center in 1969-70. In addition, there were 8 late
deaths without postmortem examination, 2 of which were sudden and 4 of
which followed rapidly progressive congestive heart failure over a period
of hours to days. Prosthetic malfunction appears to be a possible mechanism
of death in the majority of these patients. The 2 additional late deaths
were unrelated to valve malfunction. Regurgitant murmurs have been
identified during follow-up examination in 17 patients. Two patients had
prosthetic replacement for hemodynamically significant leaks through the
valve mechanism and were found to have no perivalvular leak. Six additional
patients had prophylactic replacement of the Wada-Cutter valve.
Measurements on 7 available occluders that were removed showed variable
degrees of material movement at the hinge. This experience has caused us to
recommend elective replacement of remaining Wada-Cutter valves.
