Embolized Mechanical Aortic Valve Leaflet Causing Infrarenal Aortic Stenosis and Claudication

Abstract Leaflet escape from mechanical heart valves is a rare but potentially fatal complication of prosthetic valve replacement. Historically, the incompetent valve is replaced emergently and the escaped leaflet is subsequently retrieved from its settlement in a distal vessel. If not retrieved, the fragment can increase the risk of infection, thrombosis, and migration. We report a case of a mechanical aortic valve leaflet that embolized during valve reoperation and caused occlusive aortic disease found two years later. This case emphasizes the importance of locating leaflet fragments after they are noticed missing.