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. Author manuscript; available in PMC: 2020 Jan 8.
Published in final edited form as: JACC Cardiovasc Interv. 2019 Jul 8;12(13):1197–1216. doi: 10.1016/j.jcin.2019.04.052

FIGURE 6. Confounding Transcatheter Aortic Valve Replacement Device and Implantation Characteristics.

FIGURE 6

Confounders from transcatheter aortic valve replacement (TAVR) device and implantation characteristics. (A to C) implantation characteristics including flaring, depth of implantation, and canting each significantly affect virtual valve-to-coronary (VTC) distance. (C to F) In vitro BASILICA TAVR inside a Mitroflow bioprosthetic valve using a SAPIEN 3 (D,E) and Evolut R (F,G). (D,F) TAVR device commissures are serendipitously aligned away from the laceration. (E,G) TAVR device commissures (red arrows) are aligned with the laceration and are more likely to obstruct coronary inflow. images courtesy of Danny Dvir. (H) Depiction of a SAPIEN aligning with a Mitroflow annulus and encroaching more on the left coronary artery (LCA). (I) In contrast, an Evolut R aligns with the ascending aorta and often orients away from the LCA.