Abstract
A 79-year-old man with prior bioprosthetic mitral valve replacement presented with progressive shortness of breath and was found to have right upper pulmonary vein stenosis and paravalvular leak diagnosed with the use of multimodal imaging. The patient underwent balloon angioplasty, stenting of the pulmonary vein, and paravalvular leak closure with ultimate resolution of symptoms. (Level of Difficulty: Intermediate.).