Acute mitral valve dysfunction due to leaflet escape in a Tri-technologies bileaflet mechanical valve.

Acute prosthetic valve dysfunction due to leaflet escape is a mode of structural valve failure of mechanical prostheses which is associated with a high mortality. In this report, we describe the case of a 32-year-old patient, who underwent mitral valve replacement with a Tri-technologies bileaflet valve three years ago, and was admitted to the hospital on August 2005, in cardiogenic shock. He discontinued oral anticoagulation therapy four months ago. Transthoracic and transesophageal echocardiograms showed acute-onset massive mitral regurgitation with normal left ventricular function. The patient underwent emergency surgery, during which one leaflet was found to be absent and the other leaflet was fixed due to prosthetic thrombus.