TEE. (A, B) Aortic valve short-axis view: bicuspid aortic valve with posterior thickening (noncoronary cusp; arrow) due to the vegetations, which can also be seen in (C; white arrowhead). (C) Aortic valve long-axis view. (D) Severe aortic regurgitation jet hitting the anterior mitral leaflet. See Video 1.

TEE. (A, B) Aortic valve short-axis view: bicuspid aortic valve with posterior thickening (noncoronary cusp; arrow) due to the vegetations, which can also be seen in (C; white arrowhead). (C) Aortic valve long-axis view. (D) Severe aortic regurgitation jet hitting the anterior mitral leaflet. See Video 1.

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Highlights •Mitral valve (MV) aneurysms are unusual lesions, its incidence is 0.02% to 0.29%. •Most cases of MV aneurysms are a complication of aortic valve endocarditis. •Direct Infection of MV leaflets and degenerative lesions could cause a MV aneurysms. •MV aneurysms are rarely surgical complication, however, it should be kept in mind.

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