There is evidence of aortic stenosis, aortic regurgitation and mitral regurgitation. The aortic valve leaflets are thickened, calcified and abnormal. Vegetations are possible. Moderate LV systolic failure is present. There is no pericardial effusion. This patient presented fro redo aortic valve surgery. She had a history of aortic valve repair more than 10 years ago and recent aortic valve endocarditis.