We describe the case of a 74-year-old patient with structural valve deterioration of a Carpentier-Edwards porcine mitral valve. He was referred to our institution for a murmur noted about 1 week before. Transthoracic echocardiography showed the presence of severe mitral regurgitation, without disclosing the mechanism of failure. A tear cusp was identified with transesophageal echocardiography that resulted in a lack of coaptation of the leaflets causing mitral insufficiency. The diagnosis was confirmed at surgery.