Late thrombosis of a mitral bioprosthetic valve with associated massive left atrial thrombus

Figure 1 (A) Mid-esophageal 2-chamber TEE image reveals a massive left atrial mural thrombus (yellow arrow) and markedly thickened bioprosthetic mitral leaflets (white arrow). (B) Mid-esophageal long-axis TEE image reveals a massive left atrial mural thrombus (yellow arrow) and markedly thickened bioprosthetic mitral leaflets (white arrow). (C) Off-axis TEE view of the left atrium reveals a massive left atrial thrombus (white arrow). (D) Threedimensional en face view (left atrial perspective) of the stenotic bioprosthetic mitral valve. Note the left atrial mural thrombus (black arrow).