Acute severe aortic and diastolic mitral regurgitation in a bioprosthetic aortic valve

A rare phenomenon, acute severe aortic regurgitation can lead to a variety of clinical presentations, from haemodynamic stability to cardiogenic shock. 1 The presence of diastolic mitral regurgitation in this setting significantly increases the risk of mortality.2 Among Trifecta aortic valve replacements, aortic regurgitation or mixed regurgitation/stenosis was the cause for approximately half of cases of structural valve degeneration; this model also had a significantly increased risk of requiring early re-do aortic valve intervention.3 This report highlights the presentation of acute structural valve degeneration, the potential haemodynamic consequences and important considerations for emergent re-do valvular intervention.