Marked mitral prosthesis rocking motion preceding atrioventricular groove rupture.

Rupture of the atrioventricular groove is an uncommon but dreaded complication of mitral valve replacement. We present the case of a 74-year-old male submitted to mitral valve surgery, complicated by atrioventricular groove rupture presaged by the excessive rocking movement of the prosthesis seen in the pre-discharge transthoracic echocardiogram. <Learning objective: Valvular prosthesis rocking movement has been typically associated with paravalvular leaks and fistulae. To the best of our knowledge, this is the first case to illustrate the association of excessive rocking movement with atrioventricular groove weakness, anticipating subsequent sulcus rupture and pseudoaneurysm formation.>.