Transoesophageal echocardiographic image of an aortic prosthetic valve partly obstructed by pannus. Transoesophageal echocardiographic image of an aortic prosthetic valve partly obstructed by pannus. Grey scale (left) and colour flow (right) images show that the movement of the occluder is limited in systole (arrow). LA, left atrium; LVOT, left ventricular outflow tract. Peter Groves Heart 2001;86:715-721 Copyright © BMJ Publishing Group Ltd & British Cardiovascular Society. All rights reserved.