title: Prosthetic valve dysfunction presenting as intermittent acute aortic regurgitation.
abstract: We describe the case of a 43 year old man with a history of aortic stenosis, for which he had undergone aortic valve replacement in 1991 with a 25-mm Medtronic Hall prosthesis. He presented with several acute episodes of dyspnea and flash pulmonary edema. Transthoracic and transesophageal echocardiography performed to evaluate prosthetic valve function revealed evidence of "intermittent" episodes of AI, documented on color M-mode flow mapping to have a variable duration of diastolic flow (early vs. pandiastolic) across the left ventricular outflow tract and the pulse wave Doppler in the descending thoracic aorta showed similar variability in the duration of diastolic flow reversal.
authors.affiliation: Division of Cardiology, North Shore University Hospital, Manhasset, New York 11030, USA. dfan@nshs.edu
authors.forename: Dali
authors.initials: D
authors.lastname: Fan
authors.forename: Amgad N
authors.initials: AN
authors.lastname: Makaryus
authors.forename: Anne
authors.initials: A
authors.lastname: Hamik
authors.forename: Aloke V
authors.initials: AV
authors.lastname: Finn
authors.forename: Eric M
authors.initials: EM
authors.lastname: Isselbacher
mesh_terms: D000208:Acute Disease; D000328:Adult; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging* / Q000209:etiology*; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D014463:Ultrasonography