Leaflet escape in an Edwards TEKNA mitral prosthesis

  • Shinya Higuchi
  • Iwao Matsunaga
  • Kiyokazu Koga
  • Eiichi Teshima
  • Atsuhiro Nakashima
  • Ryuji Tominaga
  • Tsuyoshi Ito
Case Report


In almost every type of artificial valve, structural failure has been described. We are reporting on a case of a sudden leaflet escape of an Edwards TEKNA mitral valve prosthesis 12 years after implantation. The patient had a sudden onset of dyspnea and severe pulmonary edema with subsequent cardiogenic shock. An emergency mitral replacement was successfully performed. A multi-detector computed tomography scanning and three-dimensional imaging showed two fragments that had embolized in the terminal aorta and the left common iliac artery. The patient presented visual field abnormality, and postoperative head computed tomography showed watershed cerebral infarction. The escaped leaflet that fractured transversely was removed, following the patient’s recovery, during cardiac surgery.


Mitral valve surgery Prosthesis failure Leaflet escape Multi-detector computed tomography 


Compliance with ethical standards

Conflict of interest

Shinya Higuchi, Iwao Matsunaga, Kiyokazu Koga, Eiichi Teshima, Atsuhiro Nakashima, Ryuji Tominaga, and Tsuyoshi Ito have no conflicts of interest to disclose.


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Copyright information

© The Japanese Association for Thoracic Surgery 2018

Authors and Affiliations

  1. 1.Department of Cardiovascular SurgeryShin-Yukuhashi HospitalYukuhashiJapan
  2. 2.Department of Cardiovascular SurgeryFukuoka Wajiro HospitalFukuokaJapan

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