ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Stefan Christiansen
Hans H. Scheld
Dieter Hammel
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Christiansen, S.
Right arrow Articles by Hammel, D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Christiansen, S.
Right arrow Articles by Hammel, D.
Related Collections
Right arrow Valve disease
Right arrowRelated Article

Ann Thorac Surg 2001;71:761
© 2001 The Society of Thoracic Surgeons

Correspondence

Leaflet escape in a Tekna valve in aortic position

Stefan Christiansen, MDa, Hans H. Scheld, MDa, Dieter Hammel, MDa

a Klinik und Poliklinik für Thorax-, Herz- und Gefäßchirurgie, Westfälische Wilhelms-Universität Münster, Albert-Schweitzer-Str 33, 48149 Münster, Germany

To the Editor

With great interest we read the paper of Hemmer and colleagues [1] dealing with leaflet escape in an original Duromedics bileaflet and a Tekna valve in the mitral position, because recently we had to replace a Tekna valve for leaflet escape in the aortic position.

A 38-year-old patient was admitted to our university for change of an aortic prosthesis because he suffered from a high-grade insufficiency of the aortic prosthesis. The patient had undergone aortic valve replacement with a Tekna valve (25 mm, Baxter Healthcare, Santa Ana, CA) for a congenital aortic stenosis 42 months ago. Due to an acute cardiac failure he had to be resuscitated. After hemodynamic stabilization a high-grade aortic insufficiency and a severe pulmonary congestion were diagnosed, so the aortic prosthesis was changed. Intraoperatively the diagnosis of leaflet escape was made. The leaflet, which had been situated below the ostium of the left coronary artery, was missing. The Tekna valve was replaced by an SJM valve (23 mm, St. Jude Medical, Minneapolis, MN). The absent leaflet was broken: one part was located at the bifurcation of the left common iliac artery and the other part on the opposite side. Both parts were removed by means of an arteriotomy after recovery from cardiac surgery. The postoperative course was uneventful and the explanted valve fragments (Fig 1) were sent to the manufacturer.



View larger version (101K):
[in this window]
[in a new window]
  		Fig 1. Explanted valve fragments.

 
Examination of the explanted parts of the prosthesis is not yet complete so we cannot comment on the reason for failure of the prosthesis. However leaflet escape is one of the most serious complications after valve replacement, with a possibly fatal outcome, so its frequency should be reduced insofar as possible. As Hemmer and colleagues [1] already mentioned, the original Edwards-Duromedics bileaflet valve (Baxter Healthcare, Santa Ana, CA) was withdrawn from the market for this reason. If other reports confirm the experience of Hemmer and colleagues and ourselves with the newly designed Tekna valve as well, implantation of this valve should only be considered with great caution.

References

  1. Hemmer W.B., Doss M., Hannekum A., Kapfer X. Leaflet escape in a Tekna and an original Duromedics bileaflet valve. Ann Thorac Surg 2000;69:942-944.[Abstract/Free Full Text]

Related Article

Leaflet escape in a Tekna valve in aortic position: reply
Wolfgang B. Hemmer
Ann. Thorac. Surg. 2001 71: 761. [Extract] [Full Text] [PDF]




This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Stefan Christiansen
Hans H. Scheld
Dieter Hammel
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Christiansen, S.
Right arrow Articles by Hammel, D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Christiansen, S.
Right arrow Articles by Hammel, D.
Related Collections
Right arrow Valve disease
Right arrowRelated Article

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS