How not to miss a bicuspid aortic valve in the echocardiography laboratory.

Figure 1. M-mode and two-dimensional (2D) diastolic frame in the parasternal long-axis view of a bicuspid aortic valve with eccentric closure (arrows). Although not diagnostic, an eccentric line of closure should prompt one to evaluate the aortic valve closely for BAV. LA = left atrium. (Modified with permission from: Kerut EK, McIlwain, Plotnick: Handbook of Echo-Doppler Interpretation 2nd Ed, Blackwell Publishing, Elmsford, New York, 2004, p. 84) Diagnosis of bicuspid aortic valve (BAV) in the busy echocardiography laboratory is important, as it is a relatively common cardiac congenital defect (up to 3% of the population),1 and requires a recommendation for