Intermittent electromechanical dissociation following mitral valve replacement with mechanical valve: a different cause

We describe the case of a 62-year-old male patient who developed intermittent electromechanical dissociation following mitral valve replacement with papillary muscle resuspension. Clinical examinations and transoesophageal echocardiography were crucial in diagnosing this potentially fatal extrinsic prosthetic valve dysfunction. The culprit was a torn-through pledgeted suture used for papillary muscle resuspension, wedged between the disc occluder and the valve ring. The resuspension sutures were removed and the patient had an uneventful recovery. This case highlights the importance of advanced evaluation and vigilant monitoring in uncovering unusual causes of prosthetic valve dysfunction.