Rare complication of bioprosthetic aortic valve replacement☆

CE-Perimount aortic bioprosthesis in a 59-year-old-man, implanted 8 years ago, showed non-infective severe structural deterioration. Preoperative echocardiogram demonstrated a prolapsing cusp (Fig. 1(A—C)); however, intra-operative echocardiogram and findings revealed a ‘missing’ leaflet (Figs. 1(D), 2(A and B) and Video 1). www.elsevier.com/locate/ejcts European Journal of Cardio-thoracic Surgery 39 (2011) e82