[Acute dysfunction of mitral bioprosthesis: Doppler expression of a musical holosystolic murmur. Apropos of 2 cases].

Two women who had been fitted with a porcine mitral valve seven years previously suddenly developed acute dysfunction of the bioprosthesis with regurgitation. In both patients physical examination revealed an intense, vibrating, musical holosystolic murmur sounding like a "goose cry" and located at the apex. Pulsed doppler showed major, jet-like, central orothetic mitral regurgitation. A harmonic graph was recorded when the doppler window was positioned upstream of the porcine valve leaflets. The finding of such a doppler signal in this clinical context suggests tearing or perforation of one cuspid and rules out the possibility of bioprosthesis degeneration.