case_images: PMC546197_01
case_images: Off axis 2-D short axis TEE view demonstrates the left atrium (LA) the prosthetic aortic valve (AV). An echolucent area (EL) around the aortic valve protruding into LA is seen with focal outpouching into the LA. This represents weakening of the wall of the aorta near the posterior aspect of the LA
case_images: 1476-7120-3-1-1.jpg
case_images: PMC546197_01_1476-7120-3-1-1.jpg
case_images: F1
case_images: There appeared to be expansion of a portion of this lucency into the left atrium during systole suggesting communication with the aorta (Fig 1) with turbulent color flow from the aorta into the left atrium (suggestive of AAF) throughout the cardiac cycle but mainly in systole as shown by color and continuous wave doppler (Figs 2 and 3).
case_images: Off axis 2-D short axis TEE view with the probe advanced further into mid-esophagus: demonstrates turbulent color flow entering the LA from the EL region of the aortic valve illustrated in Fig 1
case_images: 1476-7120-3-1-2.jpg
case_images: PMC546197_01_1476-7120-3-1-2.jpg
case_images: F2
case_images: There appeared to be expansion of a portion of this lucency into the left atrium during systole suggesting communication with the aorta (Fig 1) with turbulent color flow from the aorta into the left atrium (suggestive of AAF) throughout the cardiac cycle but mainly in systole as shown by color and continuous wave doppler (Figs 2 and 3).
case_images: Continuous wave Doppler signal across turbulent jet showing high velocity throughout cardiac cycle but predominantly in systole consistent with aorto-left atrial fistula
case_images: 1476-7120-3-1-3.jpg
case_images: PMC546197_01_1476-7120-3-1-3.jpg
case_images: F3
case_images: There appeared to be expansion of a portion of this lucency into the left atrium during systole suggesting communication with the aorta (Fig 1) with turbulent color flow from the aorta into the left atrium (suggestive of AAF) throughout the cardiac cycle but mainly in systole as shown by color and continuous wave doppler (Figs 2 and 3).