Intraoperative acute type A dissection caused by an intra-aortic filter (EMBOL-X®) in a patient undergoing mitral valve re-replacement for acute endocarditis

We report on the case of a 60-year-old male patient who underwent mitral valve re-replacement for acute mechanical valve endocarditis. When an intra-aortic filter (EMBOL-X® Inc, Mountain View, CA) was inserted through the arterial cannula in order to prevent embolization from a floating thrombus attached to the mitral valve prosthesis, our patient developed acute type A aortic dissection. This, to our knowledge, is the first report on this kind of complication using intra-aortic filter systems. Here we discuss a potential mechanism that might have led to the event of acute type A dissection in our case. Furthermore we point out strategies that might help to prevent this life-threatening complication in the future.