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. 2023 Jun 1;7(6):ytad264. doi: 10.1093/ehjcr/ytad264

Figure 2.

Figure 2

Computed tomography (A–C) showing underexpansion of transcatheter heart valve and schematic diagrams explaining this phenomenon (D–F). (A–C) The small arrows show sewing ring of Trifecta bioprosthesis, and the arrowheads show struts of Evolut PRO+. The big arrows show the right coronary leaflet of Trifecta bioprosthesis. (A) Axial view at the level of solid line showing underexpansion of Evolut PRO+. (B) Axial view at the level of dotted line showing Evolut PRO+ compressed by the calcified immobile leaflet of Trifecta bioprosthesis. (C) Sagittal view. (D–F) The circles show sewing ring, the dots show commissural posts, the bold lines in the circles show calcified immobile leaflets, and the skinny lines in the circles show normal leaflets of Trifecta bioprosthesis. The dotted line shows struts of Evolut PRO+. (D) Schematic diagram before valve-in-valve procedure in diastole. (E) Schematic diagram before valve-in-valve procedure in systole showing a calcified immobile leaflet within struts of Trifecta bioprosthesis. (F) Schematic diagram after valve-in-valve procedure in systole showing struts of Evolut PRO+ compressed by the calcified immobile leaflet of Trifecta bioprosthesis.