Figure 1. Transthoracic echocardiography demonstrated large vegetation attached at the bicuspid aortic valve leaflet (A, arrow indicated), with mild to moderate aortic stenosis and moderate to severe aortic regurgitation, severe mitral regurgitation, moderate tricuspid regurgitation and dilations of the left atrium and left ventricle (B). The second day after surgery, repeated transthoracic echocardiography demonstrated that valvular regurgitation disappeared (C). Transthoracic echocardiography revealed myocardial contractility similar to normal and no valvular regurgitation still 1 month after the surgery (D). LA: left atrium; LV: left ventricle; RV: right ventricle; AO: aorta.