{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:50:25Z","timestamp":1753876225609,"version":"3.41.2"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2022,11,7]],"date-time":"2022-11-07T00:00:00Z","timestamp":1667779200000},"content-version":"vor","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Leaflet escape is a rare complication of mechanical heart valves. The following case is the first report of leaflet escape from an On-X mechanical mitral valve in a child.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 12-year-old boy presented with acute pulmonary oedema one year after mitral valve replacement with an On-X valve for rheumatic heart disease. Transoesophageal echocardiogram diagnosed an absent mechanical mitral valve leaflet and severe mitral regurgitation for which the patient successfully underwent urgent mitral valve replacement. Computed tomography located fragments of the embolised mitral valve leaflet at the bifurcation of the abdominal aorta and within the right common iliac artery. In the absence of impaired lower limb perfusion, the leaflet fragments were left in situ. He was discharged without complication and remains asymptomatic three months post-discharge.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Leaflet fracture and escape is a known but rare complication of mechanical valve prostheses. The first-line investigation for suspected mechanical valve dysfunction is transoesophageal echocardiogram which elicited the diagnosis on this occasion.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytac439","type":"journal-article","created":{"date-parts":[[2022,11,7]],"date-time":"2022-11-07T09:08:24Z","timestamp":1667812104000},"source":"Crossref","is-referenced-by-count":0,"title":["Leaflet fracture and escape from an On-X mechanical mitral valve in a child: a case report"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5947-1208","authenticated-orcid":false,"given":"Gajon","family":"Uthayakumaran","sequence":"first","affiliation":[{"name":"Green Lane Paediatric and Congenital Cardiac Services, Starship Children's Hospital , 2 Park Road, Grafton, 1021, Auckland , New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kirsten","family":"Finucane","sequence":"additional","affiliation":[{"name":"Green Lane Paediatric and Congenital Cardiac Services, Starship Children's Hospital , 2 Park Road, Grafton, 1021, Auckland , New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Gentles","sequence":"additional","affiliation":[{"name":"Green Lane Paediatric and Congenital Cardiac Services, Starship Children's Hospital , 2 Park Road, Grafton, 1021, Auckland , New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8957-6617","authenticated-orcid":false,"given":"Bryan","family":"Mitchelson","sequence":"additional","affiliation":[{"name":"Green Lane Paediatric and Congenital Cardiac Services, Starship Children's Hospital , 2 Park Road, Grafton, 1021, Auckland , New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,11,7]]},"reference":[{"key":"2022112207521995000_ytac439-B1","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1093\/ejcts\/ezy122","article-title":"Sudden haemodynamic collapse caused by leaflet escape of the contemporary On-X mechanical valve","volume":"54","author":"Kageyama","year":"2018","journal-title":"Eur J Cardiothorac Surg"},{"key":"2022112207521995000_ytac439-B2","doi-asserted-by":"crossref","first-page":"e307","DOI":"10.1016\/j.athoracsur.2019.03.064","article-title":"Survival after mitral valve replacement for leaflet escape in a contemporary on-X mechanical valve","volume":"108","author":"Amor\u00f3s Rivera","year":"2019","journal-title":"Ann Thorac Surg"},{"key":"2022112207521995000_ytac439-B3","doi-asserted-by":"crossref","first-page":"e199","DOI":"10.1016\/j.athoracsur.2020.01.023","article-title":"Cardiogenic shock due to leaflet migration of 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Surg"},{"key":"2022112207521995000_ytac439-B10","doi-asserted-by":"crossref","first-page":"1647","DOI":"10.1016\/j.jacc.2017.07.732","article-title":"Acc\/AATS\/AHA\/ASE\/ASNC\/HRS\/SCAI\/SCCT\/SCMR\/STS 2017 appropriate use criteria for multimodality imaging in valvular heart disease A report of the American college of cardiology appropriate use criteria task force, American association for thoracic surgery, American heart association, American society of echocardiography, American society of nuclear cardiology, heart rhythm society, society for cardiovascular angiography and interventions, society of cardiovascular computed tomography, society for cardiovascular magnetic resonance, and society of thoracic surgeons","volume":"70","author":"Doherty","year":"2017","journal-title":"J Am Coll Cardiol"}],"container-title":["European Heart Journal - Case 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