INTERMITTENT MITRAL REGURGITATION AND PULMONARY-EDEMA AFTER AORTIC-VALVE REPLACEMENT

We report intermittent mitral valve regurgitation with 17 acute pulmon ary edemas over a 16-month period after aortic valve replacement due t o combined aortic valve disease in a 51-year-old man. The mechanism of mitral regurgitation was explained by the relatively large size of th e prosthetic valve which had had to be sutured partly below the aortic annulus. It was suspected to interfere with the closure of the mildly diseased mitral valve when under pressure or subjected to volume load ings of the left ventricle which provoked free mitral regurgitation. T here was no recurrence of pulmonary edema in the 50 months following m itral valve replacement.