The most commonly used aortic prosthetic heart valves may be divided into two main groups: mechanical and bioprosthetic
valves. Transthoracic echocardiography is the main imaging modality. In equivocal findings transesophageal
echocardiography is the second method of choice. Sciagraphy of the chest and computed tomography in
case of paravalvular pathology may be useful. The first echocardiography should be done after acute post-surgery
changes. Prosthesis type and size should be available for proper assessment. Prosthesis dysfunction is divided into
structural dysfunction (almost exclusively in bioprosthesis) and nonstructural dysfunction (i.e. patient – prosthesis
mismatch (PPM), pannus or paravalvular pathology, prosthetic valve thrombosis and prosthetic endocarditis. An
accurate diagnosis of prosthetic dysfunction is necessary for its proper management.