about 70 y old patient with prolonged dyspnea and interstitial oedema of lung. A condition of mitral valve replacement (Hancock biological mitral valve prosthesis) is known. In TTE (not shown) I saw a distinct regurgitation beside the mitral valve prosthesis. So in TEE I could demonstrate a distinct paraprosthetic leckage with regurgitation in left upper pulmonary vein. 3D-reconstruction could localised the paraprosthetic leckage between mitral valve prosthesis and LAA.