Transoesophageal echocardiography at J10 revealed a 13 mm vegetation on the anterior leaflet of the mitral valve in a commissural view 60° with a 3D reconstruction showing the insertion on the A1 segment near the anterior commissure (upper left and right panels, vegetation indicated by the arrow). Colour Doppler rayon PISA 14 mm in favour of severe mitral insufficiency (lower left and right panels). Anatomical landmarks: AMV, anterior mitral valve; LA, left atrium; LV, left ventricle; PMV, posterior mitral valve.