Now You See Me Now You Don’t

Figures

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  Figure 1. Transthoracic Echocardiography on Admission, Parasternal Long-Axis View Showing Severe Aortic Stenosis

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  Figure 2. Dobutamine Stress Echocardiography The imaging shows a 4.4 m/s maximal velocity across the aortic valve with a mean gradient of 41 mm Hg.

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  Figure 3. Cardiac Magnetic Resonance The red arrow shows the subaortic membrane.

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  Figure 4. Cardiac Computed Tomography (A) Cardiac computed tomography transcatheter aortic valve replacement protocol confirming the presence of a subaortic membrane in the left ventricular outflow tract. (B) Computed tomography showing the calcified trileaflet aortic valve.

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  Figure 5. Pressure Gradient Wire Measuring 30 mm Hg Across the Subaortic Membrane Area FFR = fractional flow reserve; LV = left ventricle.

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  Figure 6. Pressure Gradient Wire Measuring 0 mm Hg Across the Aortic Valve, Supra-Membrane Area Abbreviations as in Figure 5.

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  Figure 7. The Subaortic Membrane During Surgery The yellow arrow is pointing toward the subaortic membrane.

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  Figure 8. Resected Subaortic Membrane Next to the Native Aortic Valve

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  Figure 9. Postprocedural Echocardiography Showing No Stenosis Across the Aortic Valve