Presentation
The patient presents with a recurrent intracranial event. Known prosthetic mechanical mitral valve replacement and previous atrial fibrillation.
Patient Data
The study confirms median sternotomy with a mechanical radio-opaque prosthetic mitral valve.
There is persistent left atrial enlargement in view of previous mitral valve incompetence
There are features suggestive of pulmonary edema in a setting of cardiac decompensation.
The lung fields are otherwise unremarkable.
Nasogastric tube in situ, with overlying ECG leads and evidence of a previous cholecystectomy.
Case Discussion
The patient had a history of severe mitral valve incompetence, mild tricuspid valve incompetence with atrial fibrillation, and consequent multiple intracranial events.
He underwent prosthetic mechanical mitral valve replacement, left atrial appendage plication, and additionally a maze procedure to prevent further intracranial events.
He continued to develop further intracranial events and needed urgent MR imaging to confirm a recurrent acute stroke.
Fortunately, the patient has a CardiaMed prosthetic mitral valve replacement.
This particular mechanical valve is MRI compatible at 1.5 Tesla strength.
The housing and leaflets are made from pure pyrolytic carbon, a completely man-made material similar to graphite and often used in prosthetic cardiac valves and as a coating on orthopedic implants due to its non-thrombogenic properties.
The stiffening ring is made from a titanium alloy and is completely safe for MRI.
There is a reported absence of regional artifact and absence of any valve malfunction or altered function on the performance of MR imaging on these patients.
He safely underwent an MRI brain study which confirmed recurrent non-hemorrhagic infarction.
It is always important to assess all cardiac devices before any MR imaging study to prevent any adverse incidents and patient disasters.
If in doubt, revert to CT imaging temporarily and also consider chest X-rays for review and exclusion of devices in all non-responsive patients before any urgent MR imaging.
Disclosure: I, Ashesh I Ranchod, have no actual or potential ethical or financial conflict of interest in relation to this device. This case is not intended to be a personal endorsement or recommendation of this product.