Normal Functioning Tilting Disc Aortic Valve in Its Fourth Decade

We report about a middle-aged male patient with rheumatic heart disease who had undergone an older generation tilting disc prosthetic aortic valve (Björk–Shiley valve) implantation 36 years back. He presented with severe mitral stenosis and a normal functioning prosthetic aortic valve. This case may be one of the longest reported functioning Björk–Shiley valve at aortic position, associated with an uneventful course over four decades. Patients with durable older generation prosthetic heart valves may be encountered in clinical practice and need to be managed in line with current guidelines.