Cyclic intermittent aortic regurgitation of a mechanical bileaflet aortic valve prosthesis : diagnosis and clinical implications

We describe a rare case of intermittent dysfunction of a bileaflet mechanical aortic valve prosthesis. Subvalvular pannus overgrowth on the inflow aspect of the prosthesis impeded normal closure of one leaflet causing severe aortic regurgitation, which occurred intermittently. The complementary role of transthoracic and transesophageal echocardiography and cine-fluoroscopy in the diagnosis of this case is described.