Major detachment of aortic prosthetic valves

The clinical and investigatory findings in five instances of major detachment of an aortic valve prosthesis in four patients are described. This situation was associated with auscultatory and peripheral signs of aortic regurgitation and, in addition, a mid-diastolic murmur in the mitral area. From the haemodynamic and operative findings it was postulated that, in addition to severe aortic regurgitation, disturbance of mitral valve function occurred both in systole and diastole caused by the pivoting of the prosthesis attached to the base of the aortic leaflet of the mitral valve. Cardiac fluoroscopy confirmed the diagnosis.