Accessory tricuspid valve tissue (ATV) is a rare congenital cardiac malformation most commonly associated with congenital cardiac anomalies. In literature, reported cases are associated with occlusion of the ventricular septal defect (VSD) by ATV. Therefore, accurate diagnosis of ATV in patients undergoing cardiac surgery is important. We report a rare case of ATV tissue in a patient undergoing tetralogy of Fallot (TOF) repair. Introduction: Accessory tricuspid valve tissue is a rare congenital cardiac anomaly most commonly associated with congenital cardiac anomalies with varying clinical and hemodynamic features. Most of the reported cases were associated with various other intracardiac anomalies, such as TOF, transposition of a great artery, and VSD. When associated with VSDs, it can cause partial to near-complete obstruction of the VSD or it can cause right ventricular outflow tract (RVOT) obstruction. Therefore, preprocedure diagnosis and confirmation are needed when it is associated with congenital cardiac abnormalities.

Personal protective measures make traditional clinical examination difficult in the context of the novel coronavirus-2019 (COVID-19) pandemic. Point-of-care ultrasound and echocardiography may ably complement clinical examination and allow optimal management of COVID-19 as well as coexisting comorbidities. Here, the authors describe a series of cases illustrating the same and discuss how point-of-care echocardiography can be expediently and safely implemented.

The incidence of nosocomial infective endocarditis (IE) has increased in the last 2 years during the COVID-19 pandemic and the patients might present with overlapping symptoms of heart failure and pneumonia. Simultaneously, COVID-19 is a hypercoagulable disorder that can complicate the postoperative course of a patient undergoing valve replacement. Therefore, the exact pathology of the native valve needs to be evaluated in such patients. We describe a case of a 45-year-old man with a history of non-compressive myelopathy and COVID-19 infection scheduled for aortic valve replacement and subaortic membrane resection. Intraoperative transesophageal echocardiography was instrumental in defining the aortic valve anatomy that changed the management plan.

Prosthetic valve regurgitation in the immediate post-implantation period can be caused by paravalvular or transvalvular leakage. Close examination with two-dimensional (2D) as well as three-dimensional (3D) transesophageal echocardiography (TEE) is necessary for its proper diagnosis. A case of transvalvular regurgitation across a tilting disk prosthetic valve in mitral position is described here, along with the role of 3D TEE in its diagnosis. Image acquisition and optimization for 3D TEE in prosthetic valve evaluation is also briefly reviewed.

Aim and objective: To highlight the impediments for the transthoracic echo windows. Background: Pneumomediastinum and pneumopericardium with cardiac A-lines obscuring the transthoracic echo windows. Case description: A 57-year-old male patient with COVID-19 infection underwent tracheostomy and positive pressure ventilation following which he developed pneumomediastinum/pneumopericardium. Subsequently, the apical and parasternal cardiac windows replaced by A-lines hindering the echocardiographic examination. Conclusion: The disappearance of the previously available echo window should raise the suspicion of new-onset pneumomediastinum or pneumopericardium.

Massive myocardial infarction can lead to left ventricular free wall rupture (LVFWR). Sometimes it can be contained by a pericardium leading to the formation of the pseudoaneurysm. In view of the high tendency to expand and rupture an urgent surgery is indicated. We experienced a rare case of giant left ventricular apical pseudoaneurysm which was successfully managed with surgical intervention.