PMC7525298_01
TTE from parasternal long axis view showing large echodensity on the right coronary cusp. Color Doppler demonstrates AI.
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Additionally, there was eccentric aortic insufficiency (AI) graded as moderate in severity by qualitative assessment (Figure 1).
TEE from transgastric long axis view with beam path at 120 degrees showing aortic valve echodensity. Color Doppler demonstrates severe AI. Yellow arrow points to subaortic membrane.
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Interestingly, a linear structure in the left ventricular outflow tract (LVOT) was visualized, suggestive of a subaortic membrane (Figure 2).
Resected aortic valve with vegetation on the left coronary cusp and perforation of the right coronary cusp.
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He was found to have extensive phlegmon on the right coronary cusp and a perforation of the left coronary cusp of the aortic valve (Figure 3).
Intraoperative images showing the thin fibrotic subaortic membrane visible above the suction cannula.
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Additionally, inspection of the LVOT confirmed a fibrotic subaortic membrane extending from the interventricular septum to the anterior annular region of the mitral valve (Figure 4).