PMC5374812_01
Midesophageal long-axis view showing thickened and calcified mitral valve with smoke in left atrium and turbulent flow across the valve (LA: Left atrium, LV: Left ventricle, Ao: Aorta)
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F1
Intraoperative transesophageal echocardiography (TEE) confirmed the preoperative TTE findings of a severely thickened and calcified MV with a valve area of 0.6 cm2 and the presence of spontaneous echo contrast in LA [Figure 1].
Modified midesophageal four-chamber view showing normal functioning bileaflet prosthesis valve in situ in closed (a) and open (b) position. Note the absence of thrombus in left atrium
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F2
TEE and no apparent thrombus was observed in any heart chamber [Figure 2].
Modified aortic valve short-axis view showing thrombus in left atrium, aorta and right atrium
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F3
TEE revealed thrombi in all the chambers of the heart and aortic root [Figure 3]. The surgeon could not palpate the femoral pulses bilaterally.