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To assess normal prosthetic mitral valve function, multiplane transesophageal Doppler echocardiographic studies were performed on 22 patients with Monostrut tilting disk valves. Mean follow-up after implantation was 63 ± 12 months. Two holosystolic red low-velocity regurgitant jets were detected in all but one case. The length of these jets ranged from 0.8 to 6.9 cm and the area ranged from 0.5 to 10.1 cm 2 in various planes. The origin of the jets was inside the rings of the prosthetic valves and started with a mosaic spot of 2 mm maximum diameter. In this mosaic spot, jet velocity by the high pulse–repetition frequency mode measured greater than 4 m/sec. Thin, high-velocity regurgitant jets originating outside the sewing ring were present in three cases. In one case we found a high-velocity turbulent jet originating outside the ring corresponding to a paravalvular regurgitation of moderate degree. The low-velocity jets were obscured in the patient with moderate paravalvular leak but not in patients with trivial paravalvular leaks. (J Am Soc Echocardiogr 1997;10:155-8.)