Atypical clinical presentation of bileaflet cardiac prosthetic valve dysfunction. Preliminary report.

Single-leaflet disc immobilisation in 3 patients with St Jude Medical prostheses and 1 patient with a Carbo Medics valve prosthesis resulted in mild mitral regurgitation without acute pulmonary oedema. Three patients presented with slowly worsening pulmonary congestion while 1 patient had neurological symptoms. Clinicians need to be aware of the possibility of single-leaflet failure in a bileaflet cardiac valve prosthesis, because haemodynamic deterioration occurs insidiously in these patients, resulting in atypical symptoms and signs.