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. 2021 Jun 4;8:670457. doi: 10.3389/fcvm.2021.670457

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Copyright © 2021 Leone, Fazzari, Cannata, Sanz-Sanchez, Mangieri, Monti, Cozzi, Stefanini, Bragato, Colombo, Reimers and Regazzoli.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Multimodality imaging for differential diagnosis of high trans-prosthetic gradients in patients with THV. Case 1. TEE showing an isoechoic mobile mass (*) adherent to THV (arrows) cusps, causing valve obstruction; blood cultures confirmed infective endocarditis (A,B). Case 2. TEE revealing severe paravalvular (arrows) leak (C, arrowheads); the regurgitant jet is also shown during CMR cine sequences (D, arrowheads), and can be quantified using phase contrast sequences. Case 3. TEE in a patient known for valve-in-valve procedure showing an isoechoic mass (E, white star) in left coronary sinus, affecting cusp motion (arrowhead). CT (F), confirmed the mass (white star) arising between the two valves, and whose features and density were consistent with thrombus.