case_images: PMC10725942_01
case_images: Transthoracic echocardiogram and intraoperative view of the vegetations. A vegetation sizing 1.75 cm x 1.10 cm (A, arrow), as well as severe mitral regurgitation (B) were detected pre-operatively; the yellowish vegetation (arrow) was observed intra-operatively with the infiltration of aortic valve (C), anterior mitral cusp (D) and mitral annulus (E).
case_images: fcvm-10-1273255-g001.jpg
case_images: PMC10725942_01_fcvm-10-1273255-g001.jpg
case_images: F1
case_images: Transthoracic echocardiogram (TTE) assessment (on the day of admission and 1 day before the operation) unveiled numerous echogenic vegetations affixed to the anterior mitral valve, including one particularly prominent vegetation measuring 17 x 11 mm (Figure 1A, arrow). This echocardiogram also indicated severe mitral insufficiency (Figure 1B). During the operation, additional small vegetations were detected on the aortic valve (2-4 mm in diameter), along with perforation (3 mm in diameter) of the valve cusp (Figure 1C, arrow). The infective valvular vegetation, displaying a yellowish hue, was approached via the ascending aorta (Figure 1C) and interatrial septum (Figure 1D). The vegetation was successfully excised (Figure 1E), and subsequent replacement with two mechanical valves (Sorin, sizing 25 mm and 27 mm for aortic and mitral valves, respectively) was carried out.