Readmission due to progressing dyspnoea. Transoesophageal echocardiography (TOE) and 3D TOE: severe aortic paravalvular leak (PVL) confirmed outside the surgical valve ring, located at the left coronary sinus. Haemolytic anaemia (Hgb: 92–82 g/dL) detected, brain natriuretic peptide level high (7244 pg/mL). Computed tomography angiography confirms high-volume PVL and pulmonary congestion. This evidence concerns the gene NPPB and pulmonary vascular congestion.