This report describes a patient with a Björk-Shiley mitral valve prosthesis in whom transoesophageal cross sectional echocardiography revealed a large vascularised mass within the left atrial appendage with smoke-like opacification of blood flow in the left atrium. Transoesophageal cross sectional echocardiography gave a detailed image of the lesion which was unobtainable with precordial cross sectional echocardiography.
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