History
A 10-year-old girl with known rheumatic heart disease presented with severe shortness of breath. She underwent a bioprosthetic mitral valve (MV) replacement (23-mm Perimount bovine pericardial leaflets sutured inside the stent) due to severe combined mitral stenosis and regurgitation. She did well for the next 2 years and then developed shortness of breath NYHA class III that lasted 12 months.