case_images: PMC6501225_01
case_images: Midesophageal short axis view obtained on transesophageal echocardiogram performed on hospital day 3 with a focus on the right atrium, tricuspid valve, and RVOT. There was no clear, identifiable source of infection on this initial evaluation.
case_images: CRIC2019-6279019.001.jpg
case_images: PMC6501225_01_CRIC2019-6279019.001.jpg
case_images: fig1
case_images: Transthoracic echocardiogram (TTE) on hospital day 1 and TEE on day 3 were, however, noncontributory (Figure 1).
case_images: Focused midesophageal view of the RVOT on repeat TEE performed on hospital day 9. Note the large echodense structure measuring 3.4 cm x 1.6 cm that is independent of the tricuspid valve apparatus and is highly mobile with a narrow peduncle. The temporary pacemaker lead is also independent of this structure.
case_images: CRIC2019-6279019.002.jpg
case_images: PMC6501225_01_CRIC2019-6279019.002.jpg
case_images: fig2
case_images: TEE was then repeated on hospital day 9 revealing a highly mobile echodensity in the right ventricular outflow tract (RVOT) measuring 3.4 cm by 1.6 cm (Figure 2) without valve leaflet or chordae involvement.
case_images: Midesophageal RVOT-focused view on intraoperative TEE immediately postaspiration using the AngioVac system (catheter can be visualized in this image.) Although residual vegetation is visible, there is approximately 90% resolution postaspiration.
case_images: CRIC2019-6279019.003.jpg
case_images: PMC6501225_01_CRIC2019-6279019.003.jpg
case_images: fig3
case_images: Postprocedure TEE showed up to 90% resolution of the mass (Figure 3).