Fig. 3

Transesophageal echocardiography (TEE) A Four-chamber mid-esophageal TEE showing two abnormal ring-like structures on the mitral valve compatible with aneurysms (yellow arrows). B Color Doppler analysis showing a turbulent flow through a small orifice within the medial anterior mitral valve leaflet aneurysm related to a mitral regurgitation (white arrow) C Mid-esophageal TEE short axis view showing a bicuspid aortic valve with thickening of the aortic-mitral fibrous trigone indicating an aortic root abscess (blue arrow) D three-chamber mid-esophageal TEE demonstrates an anterior mitral leaflet aneurysms juxtaposed to a prominent aortic root abscess (green arrow) and vegetation of the right coronary valve (*) E Color Doppler study showed a significant aortic regurgitation with an eccentric jet directed toward the anterior mitral leaflet aneurysm. LA = left atrium, Ao = ascending aorta, LV = left ventricle