Fig. 1.

(A) IVUS of RCA showing stent fracture. (B) IVUS of RCA status-post percutaneous coronary intervention showing well opposed stent with no fracture. (C) Sinus of Valsalva (SoV) with large measurements. The ostial stent lies above the level of the SoV. (D) Pre-TAVR MDCT showing RCA stent protruding into aorta with a stent to wall distance of 25.2 mm. (E) With virtual valve implant of a 26-mm balloon-expandable transcatheter heart valve 2–4 mm below the annular plane, the top of the THV will still lie below the plane of the ostial stent. Although the frame of the THV should not interact with the stent, the 26-mm balloon could cause stent injury. (F) Balloon inflation during TAVR.

IVUS, intravascular ultrasound; RCA, right coronary artery; MDCT, multidetector computed tomography; TAVR, transcatheter aortic valve replacement.