Extensive dehiscence of a stentless bioprosthesis with only mild paravalvular regurgitation after replacement of a degenerated bicuspid aortic valve.

We report the case of a 54-year-old patient admitted for rehabilitation after implantation of a stentless bioprosthesis due to severe insufficiency of a degenerated bicuspid aortic valve. The patient could fully participate in a standard cardiac rehabilitation program without any signs of haemodynamic instability. Transthoracic echocardiography showed a small mobile subvalvular structure and only mild paravalvular reflux. Transesophageal echocardiography, however, revealed extensive dehiscence of the bioprosthesis with the need for urgent reoperation. We discuss the probable causes and encourage routine echocardiography after valve operations with generous application of transesophageal echocardiography in every suspicious case.