case_images: PMC11799943_01
case_images: (A) Complex aortic para-valvular appearance with abnormal soft tissue density (black arrow) and para-valvular calcifications; posterior aortic root thickening with heterogeneous appearance seen on (B) long-axis and (C) short-axis transoesophageal echocardiogram images; (D) intense uptake by FDG positron emission tomography surrounding aortic valve prosthesis, concerning for para-valvular abscess.
case_images: ytaf004f1.jpg
case_images: PMC11799943_01_ytaf004f1.jpg
case_images: ytaf004-F1
case_images: After completion of his IV antibiotics, a repeat TEE was performed with initial interpretation concerning for evolving aortic root abscess and possible vegetation of the aortic valve (Figure 2, Supplementary material online, Videos 3 and 4).
case_images: Transoesophageal echocardiogram images of bioprosthetic aortic valve by (A) long-axis and (B) short-axis views. Although the long-axis image demonstrates stable findings compared with Figure 1B, the short-axis images demonstrate a more prominent fluid space than previously recognized. This tomographic plane is more inferior (lower in the aortic root); therefore, it is challenging to determine whether this represented an evolving fluid space or a different representative tomographic plane.
case_images: ytaf004f2.jpg
case_images: PMC11799943_01_ytaf004f2.jpg
case_images: ytaf004-F2
case_images: After completion of his IV antibiotics, a repeat TEE was performed with initial interpretation concerning for evolving aortic root abscess and possible vegetation of the aortic valve (Figure 2, Supplementary material online, Videos 3 and 4).
case_images: (A) Computed tomography scan performed prior to first re-do operation demonstrating abnormal contrast accumulation between aortic graft and native aortic tissue following modified inclusion root technique with nearby soft tissue density (white arrows). (B) Persistent soft tissue abnormalities with para-valvular calcifications following re-do total root reconstruction (white arrows). Findings are identical to computerized tomography performed during index hospitalization (Figure 1A).
case_images: ytaf004f3.jpg
case_images: PMC11799943_01_ytaf004f3.jpg
case_images: ytaf004-F3
case_images: After completion of his IV antibiotics, a repeat TEE was performed with initial interpretation concerning for evolving aortic root abscess and possible vegetation of the aortic valve (Figure 2, Supplementary material online, Videos 3 and 4).