INTRODUCTION
Appropriate follow-up after surgical implantation of bioprostheses ensures the timely detection of dysfunctional heart valves and their replacement in a safe manner (1,2). Nonetheless, catastrophic structural valve deterioration can occur (1-5) early or late postoperatively (6.7). We describe the clinical presentation, management and outcome of a patient who suffered cuspal tear of a bioprosthetic mitral valve four years post valve
implantation, and discuss her case in context with the pre-existing relevant literature.