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CASE REPORT
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Aortic dissection masquerading as a bicuspid aortic valve


 Department of Anesthesiology, University of North Carolina, Chapel Hill, North Carolina, USA

Correspondence Address:
Priya Ajit Kumar,
Department of Anesthesiology, N2198 University of North Carolina Hospitals, Campus Box 7010, Chapel Hill, NC 27599-7010
USA
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Source of Support: None, Conflict of Interest: None

A 37-year-old male presented to the Emergency Department with acute worsening of back pain and new onset dyspnea. Transthoracic echocardiography revealed moderate left ventricular dysfunction and a bicuspid aortic valve (BAV). In addition, he was noted to have a dilated thoracic aorta concerning for a dissection, severe aortic insufficiency (AI), and both a pericardial and pleural effusion. Magnetic resonance imaging revealed a Type A ascending aortic dissection. He was taken emergently to the operating room for repair. An intraoperative transesophageal echocardiography examination was performed which revealed a normal trileaflet AV with a Type A aortic dissection flap masquerading as a BAV. The dissection flap interfered with both the valve's function, causing severe AI, as well as the valve's appearance, causing it to look bicuspid on echocardiography.


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    -  Arora H
    -  Kumar PA
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