[Unusual fatal late complication after aortic valve replacement]

A Björk-Shiley valve was totally torn and embolised into the abdominal aorta in a 41-year-old man from the initial aortic position. Heavy thrombotic masses arrested the valve disc in a quarter-maximal opening position. Sutures were intact and adhered to the valve ring. Bacterial endocarditis could not be demonstrated. Probably the increasing pressure gradient had led to tearing of connective tissue in progressive valve thrombosis followed by embolisation of the valve.