Bioprosthetic valve degeneration on transesophageal echocardiography (short axis)

Typical appearance of bioprosthetic degeneration on transesophageal echocardiography. In this patient, aortic prosthetic mean gradient increased to 37 mmHg at 4 years after surgical implantation. The short-axis view shows the echo-bright, fused left and noncoronary cusps. Signal intensity in the affected cusps is similar to the one in the prosthetic struts and higher than the unaffected cusp or soft tissues.