Transesophageal echocardiogram long-axis view of the aortic valve without color flow showing the left to right shunt through the outlet VSD and right coronary cusp prolapse. VSD: ventricular septal defect; LVOT: left ventricular outflow tract; RVOT: right ventricular outflow tract. The white arrow denotes VSD and the black arrow denotes the right coronary cusp of the aortic valve.