PMC5109564_01
Transthoracic echocardiogram. A: A parasternal long-axis view on the 2nd hospital day. B: A parasternal long-axis view showing a large vegetation attached to the apical part of the left ventricle.
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The next day, transthoracic echocardiography (TTE) showed that her cardiac function had gradually improved without any valvular abnormalities (Fig. 1A). Ten days later, TTE showed a large mobile and solid mass attached to the apical part of the left ventricular apex without any valvular abnormalities (Fig. 1B).
A: The arrow shows a vegetation that developed from the left ventricular endocardium. The arrowhead shows the mitral valve. B: Macroscopic findings of the 3 cm long vegetation.
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Gentamicin was subsequently added as a standard therapy of infectious endocarditis, and the patient underwent urgent surgery (Fig. 2A). A pedunculated mass originating from the apex of the left ventricle was exposed and excised with a substantial portion of the normal myocardium (Fig. 2B).