The echophonocardiographic features in three patients with a mitral Björk-Shiley prosthesis and paravalvular regurgitation are presented. The characteristic features are an early diastolic humping of the Björk-Shiley disc echo, associated with normal rather than paradoxical septal motion, and a reduced A2-MVO interval. The diagnosis was confirmed at operation in one patient, at cardiac catheterisation and operation in the second, and at necropsy in the third. These features were abolished by surgical correction of the leak in both operated cases.
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