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A tilting valve
  1. R A TIO,

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A 38 year old man was admitted to hospital because of fatigue and progressive dyspnoea. He had a prosthetic aortic valve implanted at age 22 years because of aortic regurgitation owing to bacterial endocarditis. Physical examination revealed a systolic and diastolic murmur. Chest radiography showed an abnormal position of the prosthetic aortic valve. Cineradiography was done because of suspicion of aortic valve detachment. Two consecutive frames are shown from of an antero–posterior view. The left panel shows the valve in the aortic position, the next frame (right panel) shows the entire valve is displaced during early systole.

The patient was operated shortly after the cineradiography. The aortic valve ring was hanging loose and connected with just two remaining sutures. He received a new valve and was doing well six months after the operation.