We present a case of a 70 year-old woman operated due to severe mitral regurgitation. Early after surgery transthoracic
echocardiography revealed the decreased effective orifice area of the implanted bioprosthetic valve and the stenotic features
of transvalvular flow. Transesophageal echocardiography (TEE) disclosed a thrombotic cause of heterograft dysfunction. Due
to the clinical deterioration and the unclear cause of prosthesis stenosis, the patient was reoperated. Intra-operatively bioprosthetic
mitral valve thrombosis was confirmed. Precipitating factors of this rare complication including cardiac devicerelated
infective endocarditis (CDRIE) and the diagnostic applicability of TEE in this clinical scenario are discussed.We present a case of a 70 year-old woman operated due to severe mitral regurgitation. Early after surgery transthoracic echocardiography revealed the decreased effective orifice area of the implanted bioprosthetic valve and the stenotic features of transvalvular flow. Transesophageal echocardiography (TEE) disclosed a thrombotic cause of heterograft dysfunction. Due
to the clinical deterioration and the unclear cause of prosthesis stenosis, the patient was reoperated. Intra-operatively bioprosthetic mitral valve thrombosis was confirmed. Precipitating factors of this rare complication including cardiac devicerelated
infective endocarditis (CDRIE) and the diagnostic applicability of TEE in this clinical scenario are discussed
