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Eur J Cardiothorac Surg 2001;19:729-731
© 2001 Elsevier Science NL

Case report

Silver-coated prosthetic heart valve: a double-bladed weapon

Department of Cardiovascular Surgery, Sion Regional Hospital, Sion, Switzerland

Received 18 December 2000; received in revised form 2 March 2001; accepted 10 March 2001.

Corresponding author. Service de Chirurgie Cardiovasculaire – BH10, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 46, 1011 Lausanne, Switzerland. Tel.: +41-21-314-2280; fax: +41-21-314-2278
e-mail: tozzig{at}hotmail.com

A St. Jude Medical Silzone was implanted in a 72-year-old female, suffering from mitral valve disease. Four months later, the patient had acute cardiac failure due to partial detachment of the prosthetic valve. The mitral annulus was ulcerated and there were multiple erosions in the myocardial tissue in contact with the prosthetic valve. Histological examination revealed chronic inflammation with hemosiderine deposits and giant cells. No allergy to silver ions was found. The silver-coated sewing cuff had caused a chronic inflammatory reaction due to a toxic reaction to silver. The Silzone valve was withdrawn from the market on January 2000.

Key Words: Silver toxicity • Endocarditis • Prosthetic heart valve

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