Figure 1

Echocardiography of mitral prosthesis: A) Transthoracic echo reveals immobilization of the mechanical bileaflet with accelerated velocity of transvalvular blood flow; B) and C) Intraoperative transesophageal echo demonstrated prosthetic valve obstruction due to pannus formation (asterisks) on atrioventricular side. LA indicates left atrium; LV indicates left ventricle.