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Recognising bicuspid aortic stenosis in patients referred for transcatheter aortic valve implantation: routine screening with three-dimensional transoesophageal echocardiography
  1. B Unsworth,
  2. I Malik,
  3. G W Mikhail
  1. Correspondence to Beth Unsworth; bunsworth77{at}

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Severe aortic valve stenosis was discovered incidentally during preoperative workup for hernia repair in a 78-year-old man. He was deemed high risk for conventional surgical aortic valve replacement because of poor lung function and was consequently assessed for transcatheter aortic valve implantation (TAVI).

An initial transthoracic echocardiogram was performed to confirm the leaflet insertion diameter. Although heavily calcified, the aortic annular region was clearly visualised and a leaflet insertion diameter of 24 mm was recorded (panel A …

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  • Funding Other funders: British Heart Foundation.

  • Competing interests None.

  • Ethics approval The case discusses findings following a routine transoesophageal echocardiography performed at the echocardiography department of St Mary's Hospital. Requested via outpatient ref system for transcatheter aortic valve implantation assessment.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; not externally peer reviewed.

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