An enigmatic presentation of surgical bioprosthetic aortic valve stenosis

A 63 year old woman with a history of atrial flutter, hypertension and bicuspid aortic valve status post aortic valve replacement presented with worsening dyspnea and presyncope and echocardiography findings of bioprosthetic valve dysfunction. Imaging found a non-infectious pseudoaneurysm, with subsequent redo sternotomy finding of BioGlue causing increasing gradients.