A 48-year-old woman presented with heart failure and bioprosthetic pulmonary valve regurgitation 2 years after pulmonary Ball - Shoes Rubber - Mens valve replacement.Intracardiac echocardiography demonstrated uniform thickening of a single prosthetic valve leaflet suggesting leaflet thrombosis rather than bioprosthetic valve degeneration.After 3 months of anticoagulation, valve regurgitation and symptoms improved.
(Level Sandwich Puch of Difficulty: Intermediate.).