Interesting case.!

My assessment on these 2 TEE/TOE views (short axis mid-gastric & 5 chamber transesophageal view) shows preserved LV systolic function, LVEF 65%, mild LA enlargement, RA not well visualized, RV normal size and function with normal motion of TV, calcific AV noted. The MV leaflets have normal motion. However, there is large size (~ 1 cm) mobile globular echo density attached to the ventricular surface of the anterior mitral valve leaflet. I won't comment if it is calcified our note because the echo is over gained. Fibroelastoma would be on the top of my differential, thrombus and vegetation are less likely.

Let's see what other colleagues think!

Thank you for sharing.!