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Transesophageal echocardiography (TEE) shows a long-axis (A) and short-axis (B) view of thickened aortic valve leaflets, along with 3D reconstruction (C and D).
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Perioperative transesophageal echocardiography (TEE) was negative for apparent aortic valve vegetations but revealed a perforation of the fused leaflet (Fig. 1).
Bicuspid aortic valve following aortic valve replacement surgery demonstrating perforation of the leaflet.
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During the surgery, an area of abnormal pink tissue along with the leaflet perforation were noted in the native aortic valve area and was subsequently sent for cultures (Fig. 2).