Detection of Valve Malfunction after Mechanical MVR using Digital Phonocardiography

: We present the case of a 63-year-old female patient who developed severe chronic dyspnea two years after mechanical mitral valve replacement (MVR). Conventional cardiac diagnostics including echocardiography, fluoroscopy, right and left heart catheterization could not detect any malfunction. Only digital phonocardiography was able to show alterations of the typical acoustic signal. Based on the symptoms, the clinical history and these abnormal findings the decision was taken to reoperate. Intraoperatively, a ruptured tendinous chord was found, impeding the inferior leaflet. Redo MVR was performed.