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Figure 1 Aortic Annulus Dimension Assessed by Both TTE and TEE

(A) Accurate transthoracic echocardiography (TTE) measurement of the aortic annulus is essential to determine a patient's suitability for percutaneous heart valve (PHV) placement. Patients are deemed unsuitable if the aortic annulus is either too large (>26 mm) or (rarely) too small. The TTE image shows a zoomed-in parasternal long-axis view of the aortic annulus. The aortic annulus measures 24 mm. (B) Before PHV deployment, transesophageal echocardiography (TEE) is used to check the aortic annulus measurement obtained by TTE. A difference of up to 4 mm between the TTE and the TEE annulus measurements can occur and may lead to a change in device size. Transesophageal echocardiography long-axis image of the patient as shown in panel A shows the aortic annulus measured at 28 mm.