Evaluation of subvalvular pannus formation in mechanical aortic valve by transesophageal echocardiography.

Subvalvular pannus formation is a rare but clinically important complication with prosthetic valves. Transthoracic echocardiography still plays a role in the initial assessment of mechanical aortic valve dysfunction. But evaluation with transesophageal echocardiography is more useful. Subvalvular area may be a blind spot of echocardiography due to acoustic shadowing. The case presented herein underlines the significant role of transgastric plane and three-dimensional TEE in the assessment of subvalvular pannus formation in mechanical aortic valves.