Figure.

Transcatheter aortic valve implantation (TAVI) using the Navitor valve. (A) The Navitor valve could not be passed across the aortic arch. (B,C) Preprocedural computed tomography revealed massive calcification (white arrows) in the greater curvature of the aortic arch. (D) Rotating the system (curved arrows) and pulling back the guidewire (dashed arrow) did not solve the problem. (E,F) A snare catheter (white arrowhead; E) was used to change the wire bias (white arrows; F). (G–J) The Navitor delivery system was positioned in the aortic valve (G,H) and successfully implanted without complications (I,J).