Transthoracic and
transesophageal echocardiogram studies showed moderate
pericardial effusion, a bicuspid aortic valve with a 6mm
diameter vegetation over the commissure, and a
perivalvular abscess with a length of approximately twothirds
the aortic root diameter along the left coronary
cusp, which communicated with the aortic root (Fig. 1B).