Fig. 4

A 34-year-old man presents with dyspnoea; he has a history of intravenous drug use, having previously undergone an aortic valve replacement for S. aureus endocarditis. (a) A still 3-chamber image from a TTE demonstrates a large hypoechoic fluid collection (double arrows) between the prosthetic aortic valve (curved arrow) anteriorly and the left atrium posteriorly, with possible communication with the left ventricular outflow tract [LVOT (*)]. (b) A 3-chamber CMR SSFP image demonstrates a large pseudoaneurysm (double arrows) arising from the LVOT (*), a sequela of prosthetic valve endocarditis. Note the artefact from the aortic valve prosthesis (curved arrow). An (c) axial ECG-gated cardiac CT angiogram and (d) 3-chamber CT MPR demonstrates the large pseudoaneurysm (double arrows) arising from the LVOT (*), inferior to the prosthetic aortic valve (curved arrow). The patient underwent surgical aortic root replacement and pseudoaneurysm repair. Ao = aorta; LA = left atrium; LV = left ventricle; RA = right atrium; RV = right ventricle