Midesophageal aortic valve long-axis view. Echo dense image (red arrow) posteriorly located to the mechanical aortic valve extending toward the roof wall of the LA. Color Doppler shows an accelerated flow in the midcavity of LA. There is no flow inside the intramural hematoma or communication with LA or pericardial space. ∗Left atrium. ∗∗Left ventricle. ∗∗∗Aorta and aortic prosthetic valve.