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A 64-year-old woman had a mitral valve repair 10 years previously and subsequently had her mitral valve replaced for recurrence of severe mitral regurgitation with a 29-mm St Jude's bileaflet mechanical prosthesis at another institution 5 years ago. She presented to our department following a recent transient ischaemic attack and an echogenic lesion was picked up on the sewing ring of her mitral prosthesis (figure 1A, see online supplementary video 1).
Contributors JZ and PS: conception of the draft and final approval of the version to be published. DR: design and drafting the article.
Competing interests None.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.
▸ Additional material is published online only. To view please visit the journal online (http://dx.doi.org/10.1136/heartjnl-2013-304139).