Hi coffeelover (I love coffee as well),
Some trivial regurgitation is normal for a mechanical valve but not mild to moderate regurgitation.
You probably know this stuff but I didn't and many on the forums won't. The Top Hat mechanical aortic valve sits supra annular. As the diagram below shows, it sits a bit above the narrowest part of the outlet. This allows a larger valve to be used - useful in petite people. It is sutured in place.
It is very rare for a mechanical valve to structurally fail. This means that something else is probably going on.
Firstly, is the measurement real? The next scan will show.
Secondly, I agree with Pellicle's list of possibilities:
1) Thrombus obstruction - clot sitting in or around the valve. Not a great thing. Needs treatment.
2) Pannus - growth of tissue that it is starting to interfere with the valve
3) Paravulvular leak - blood is flowing backwards around an edge of the valve where it is sutured in. A paravulvular leak would have been obvious on the echo.
Personally, I would ask your cardiologist some questions. What is causing it. Are they sure? (A wait and see approach with a thrombus sounds like a bad idea. It is not always easy to tell thrombus apart from pannus). Once you know what the cause is, what are the treatment options? Should the surgeon be involved in the discussions?
Hopefully, someone on these forums who had a similar experience, will add further insights.
Best wishes. A mild to moderate regurgitation itself shouldn't give you any symptoms. What is causing it is the question.