case_images: PMC10874589_01
case_images: PCI scan. Still image from TTE that occurred before PCI. Green arrow shows an intact aortic valve.. PCI - percutaneous coronary intervention; TTE - transthoracic echocardiogram
case_images: cureus-0016-00000052560-i01.jpg
case_images: PMC10874589_01_cureus-0016-00000052560-i01.jpg
case_images: FIG1
case_images: Transthoracic echocardiogram (TTE) revealed an ejection fraction of 58%, grade II left ventricular diastolic dysfunction, trace aortic valve regurgitation, right ventricular dilation, mild tricuspid regurgitation, and right ventricular systolic pressure of 35 mmHg and intact aortic valve (Figure 1). This finding was in stark contrast to the previous transthoracic echocardiogram 10 days prior, which showed only trace aortic regurgitation without a mobile echodensity (Figure 1). 
case_images: PCI scan. Still image from PCI. Red arrow: catheter descending from the aorta with dye flowing through it. Green arrow: tip of the catheter near aortic valve location. Pink arrow: right coronary ostia. Blue arrows: right coronary artery with very faint amount of dye entering the artery. Yellow arrows: large amount of dye blowing back into the aorta.. PCI - percutaneous coronary intervention
case_images: cureus-0016-00000052560-i02.jpg
case_images: PMC10874589_01_cureus-0016-00000052560-i02.jpg
case_images: FIG2
case_images: Finally, success was finally obtained in entering the right coronary ostium using an AR 2 catheter (Figure 2).
case_images: New aortic insufficiency. New aortic insufficiency was found on intraoperative TTE prior to CABG and aortic valve repair and replacement.. TTE - transesophageal echocardiogram; CABG - coronary artery bypass graft surgery
case_images: cureus-0016-00000052560-i03.jpg
case_images: PMC10874589_01_cureus-0016-00000052560-i03.jpg
case_images: FIG3
case_images: A transesophageal echocardiogram (TTE) revealed new 2+ aortic insufficiency (Figure 3) with a large, mobile echodensity at the right coronary cusp of the aortic valve (Figures 4-6).
case_images: Mobile mass. AV LAX view showing mobile mass attached to AV during systole (green arrow). AV - aortic valve; LAX - long axis
case_images: cureus-0016-00000052560-i04.jpg
case_images: PMC10874589_01_cureus-0016-00000052560-i04.jpg
case_images: FIG4
case_images: A transesophageal echocardiogram (TTE) revealed new 2+ aortic insufficiency (Figure 3) with a large, mobile echodensity at the right coronary cusp of the aortic valve (Figures 4-6).
case_images: Mobile mass. AV LAX view showing mobile mass attached to AV Right coronary cusp prolapsing into LVOT (green arrow). AV - aortic valve; LAX - long axis; LVOT - left ventricular outflow tract
case_images: cureus-0016-00000052560-i05.jpg
case_images: PMC10874589_01_cureus-0016-00000052560-i05.jpg
case_images: FIG5
case_images: A transesophageal echocardiogram (TTE) revealed new 2+ aortic insufficiency (Figure 3) with a large, mobile echodensity at the right coronary cusp of the aortic valve (Figures 4-6).
case_images: Mobile mass. 3D view of mobile mass taken from LVOT (green arrow). LVOT - left ventricular outflow tract
case_images: cureus-0016-00000052560-i06.jpg
case_images: PMC10874589_01_cureus-0016-00000052560-i06.jpg
case_images: FIG6
case_images: A transesophageal echocardiogram (TTE) revealed new 2+ aortic insufficiency (Figure 3) with a large, mobile echodensity at the right coronary cusp of the aortic valve (Figures 4-6).