Surgical Removal of The Mechanical Valve Leaflet Dislocated into The Pulmonary Vein

Accidental detachment of mechanical valve leaflet during implantation is a rare and potentially serious complication. When the lost leaflet cannot be found by direct visualisation, additional diagnostic procedures are necessary to detect it. Computer tomography is the best detection method, but the patient needs reoperation. We presented a patient in whom the detached leaflet migrated and became trapped into the left inferior pulmonary vein. The computed tomography (CT) scan was used to reveal leaflets, and successful extirpation was performed in the second operation.

Keywords:
Aortic Valve; Pulmonary Veins; Tomography; X-Ray Computed; Mitral Valve

Authorship

Djordje Zdravkovic

Department of Cardiac Surgery, Dedinje Cardiovascular Institute, Belgrade, Serbia.Dedinje Cardiovascular InstituteSerbiaBelgrade, SerbiaDepartment of Cardiac Surgery, Dedinje Cardiovascular Institute, Belgrade, Serbia.

Igor Zivkovic

School of Medicine, University of Belgrade, Belgrade, Serbia.University of BelgradeSerbiaBelgrade, SerbiaSchool of Medicine, University of Belgrade, Belgrade, Serbia.

https://orcid.org/0000-0001-9601-4201

Vladimir Kovacevic

Department of Radiology, Dedinje Cardiovascular Institute, Belgrade, Serbia.Dedinje Cardiovascular InstituteSerbiaBelgrade, SerbiaDepartment of Radiology, Dedinje Cardiovascular Institute, Belgrade, Serbia.

Petar Milacic

School of Medicine, University of Belgrade, Belgrade, Serbia.University of BelgradeSerbiaBelgrade, SerbiaSchool of Medicine, University of Belgrade, Belgrade, Serbia.

Miroslav Milicic

School of Medicine, University of Belgrade, Belgrade, Serbia.University of BelgradeSerbiaBelgrade, SerbiaSchool of Medicine, University of Belgrade, Belgrade, Serbia.

Correspondence Address: Igor Zivkovic, https://orcid.org/0000-0001-9601-4201 Department of Cardiac Surgery, Dedinje Cardiovascular Institute, Heroja Milana Tepica 1, Belgrade, Serbia, Zip code: 11000, E-mail: igor88zivkovic@gmail.com

This study was carried out at the Department of Cardiac Surgery, Dedinje Cardiovascular Institute, Belgrade, Serbia.

No conflict of interest.

SCIMAGO INSTITUTIONS RANKINGS

School of Medicine, University of Belgrade, Belgrade, Serbia.University of BelgradeSerbiaBelgrade, SerbiaSchool of Medicine, University of Belgrade, Belgrade, Serbia.

Figures | Tables

Figures (3)
Tables (2)

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Fig. 1
CT scan revealed a mechanical aortic valve hemidisc into the inferior left pulmonary vein. (A) Native computed tomography scan. (B) 3D volume rendering reconstruction of the chest. White arrow=artificial valve hemidisc. Ao=aorta; HL=hilum of the lung; LV=left ventricle; PA=pulmonary artery

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Fig. 2
Extracted mechanical valve hemidisc.

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Fig. 3
Surgical view of the sutured left inferior pulmonary vein. White arrow = left inferior pulmonary vein

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Abbreviations, Acronyms & Symbols

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Authors’ Roles & Responsibilities

Fig. 1 CT scan revealed a mechanical aortic valve hemidisc into the inferior left pulmonary vein. (A) Native computed tomography scan. (B) 3D volume rendering reconstruction of the chest. White arrow=artificial valve hemidisc. Ao=aorta; HL=hilum of the lung; LV=left ventricle; PA=pulmonary artery

Fig. 2 Extracted mechanical valve hemidisc.

Fig. 3 Surgical view of the sutured left inferior pulmonary vein. White arrow = left inferior pulmonary vein

Abbreviations, Acronyms & Symbols

CT	= Computed tomography

Authors’ Roles & Responsibilities

DZ	Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; drafting the work or revising it critically for important intellectual content; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved; final approval of the version to be published
IZ	Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; drafting the work or revising it critically for important intellectual content; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved; final approval of the version to be published
VK	Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; drafting the work or revising it critically for important intellectual content; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved; final approval of the version to be published
PM	Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; drafting the work or revising it critically for important intellectual content; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved; final approval of the version to be published
MM	Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; drafting the work or revising it critically for important intellectual content; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved; final approval of the version to be published

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Surgical Removal of The Mechanical Valve Leaflet Dislocated into The Pulmonary Vein

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[1] Correspondence Address: Igor Zivkovic, https://orcid.org/0000-0001-9601-4201 Department of Cardiac Surgery, Dedinje Cardiovascular Institute, Heroja Milana Tepica 1, Belgrade, Serbia, Zip code: 11000, E-mail: igor88zivkovic@gmail.com