Fig. 1

a Transesophageal echocardiography demonstrating the shunt between the left ventricle and right atrium. b Transthoracic echocardiography demonstrating the vegetation inserted above the septal leaflet of the tricuspid valve. c Cardiac magnetic resonance demonstrating a communication between the left ventricle and right atrium and right ventricle according to (d). C-type acquired Gerbode defect representing a supravalvular combined with n infravalvular communication between the left and right side of the heart