Annals of Cardiac Anaesthesia Annals of Cardiac Anaesthesia Annals of Cardiac Anaesthesia
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INTERESTING IMAGES Table of Contents   
Year : 2010  |  Volume : 13  |  Issue : 3  |  Page : 260
Interesting TEE image

Anaesthesia and Intensive Care, Narayana Hrudayalaya Institute of Medical Sciences, Anekal Taluk, Bangalore - 560 099, India

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Date of Web Publication6-Sep-2010

How to cite this article:
Kanchi M. Interesting TEE image. Ann Card Anaesth 2010;13:260

How to cite this URL:
Kanchi M. Interesting TEE image. Ann Card Anaesth [serial online] 2010 [cited 2022 Dec 8];13:260. Available from:

A 39-year-old, female weighing 47 kg presented to the hospital with clinical features of congestive cardiac failure 3 months after the delivery of a child. She gave a history of intermittent high-grade fever and increasing dyspnoea during these 3 months. Auscultation of the chest revealed diastolic murmur of aortic regurgitation and pansystolic murmur of mitral regurgitation. Echocardiography revealed severe aortic and mitral regurgitation. The patient was scheduled for double valve replacement. Intra-operative transesophageal echocardiography showed dilated left ventricular (LV) cavity, severe mitral and aortic regurgitation, dilated mitral annulus and vegetations on non-coronary and left coronary cusps of the aortic valve, and aortic root abscess behind the non-coronary cusp, a picture suggestive of infective endocarditis [Figure 1],[Figure 2],[Figure 3],[Figure 4]. She underwent successful closure of the aortic abscess cavity and double (aortic and mitral) valve replacement. She was discharged home on advice to continue antibiotics for 4 weeks and to continue warfarin.
Figure 1: Midesophageal -aortic valve short-axis view showing aortic root abscess (shown by arrow) in relation to non-coronary cusp: aortic valve in closed position in diastole

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Figure 2: Midesophageal-aortic valve short-axis view showing the aortic valve in open position during systole: vegetation (shown by arrow) on the leaflets is noted

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Figure 3: Midesophageal four-chamber view showing abscess (shown by arrow) at the origin of the aorta in close proximity to the mitral annulus and dilated left ventricle

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Figure 4: Midesophageal-LV long-axis view showing vegetation (shown by arrow) on the aortic valve leaflets and root abscess

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Correspondence Address:
Muralidhar Kanchi
Consultant and Professor, Anaesthesia and Intensive Care, Narayana Hrudalaya Institute of Medical Sciences, #258/A Bommasandra Industrial Area, Anekal Taluk, Bangalore - 560 099
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0971-9784.69055

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  [Figure 1], [Figure 2], [Figure 3], [Figure 4]