Mitral Stenosis and Regurgitation due to Late Prosthetic Aortic Valve Migration.

We report a rare case of mitral stenosis and regurgitation after aortic valve replacement due to prosthetic valve migration. A 74-year-old woman underwent aortic valve replacement using a Carpentier-Edwards PERIMOUNT valve (Edwards Lifesciences) 9 years prior. Six years postoperatively, outpatient echocardiography incidentally revealed abnormal rocking motion of the bioprosthesis, with no signs of infection or paravalvular leak. Finally, the bioprosthetic valve interfered with the anterior mitral valve leaflet, causing severe mitral stenosis and regurgitation. Redo aortic valve replacement and mitral valve replacement with the commando procedure were performed, and pathologic findings revealed no evidence of connective tissue disease, aortitis, or infection.