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A 78-year-old man presented with a short history of severe dyspnoea and bradycardia (2:1 heart block, 30 bpm). Examination showed an ejection systolic murmur, and echocardiography showed a heavily calcified aortic valve with a peak gradient of 90 mm Hg. A large mobile mass (1.2×1.5 cm) was also observed in the region of the left ventricular outflow tract (panel A). Angiography was then …