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

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Correspondence

Leaflet escape in a Tekna valve in aortic position: reply

^a Sana Herzchirurgische Klinik, Herdweg 2, D-70174 Stuttgart, Germany

To the Editor

This case study by Christiansen and associates reports on yet another incidence of leaflet escape in a Tekna valve prosthesis. The accompanying figure clearly shows a near-central fracture of a leaflet similar to that which we [1] originally described of the same prosthesis type but in the mitral position.

The investigation in our case showed local loss of pyrolytic carbon. The second case that we described was shown to have a fracture in the area of the pivot balls, which was reported for the original Duromedics prosthesis fracture.

It is not yet clear whether the investigation into the cause for this further report of a leaflet fracture in a Tekna prosthesis will provide any additional information. What is exceptional in this case report though is the implantation site at which this leaflet escape occurred. Leaflet escape is more often described in the mitral position than the aortic because of the greater pressure gradients and subsequent mechanical stresses of the mitral valve as compared with the aortic valve. This was the case in our report and also in earlier reports [1].

The clinician is unable to draw any firm conclusions with regard to the use and handling of Tekna prostheses from isolated reports. It is instead the responsibility of the company that manufactures these valve prostheses to provide adequate registration of all reports of prosthesis malfunction, to investigate the causes thereof, and in the case of abnormal performance to make these facts known to the surgeon and patients.

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]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Wolfgang B. Hemmer Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Hemmer, W. B. Search for Related Content PubMed Articles by Hemmer, W. B. Related Collections Valve disease Related Article