TABLE 3.
Step | Figure |
---|---|
1. Define the exact annular plane. | Figure 1 |
2. Measure coronary artery heights, STJ height, and sinus of Valsalva diameters. | Online Figure 1 |
3. Do leaflet tips extend beyond coronary ostia or STJ? | Online Figure 2 |
4. Select the outer diameter(s) of the intended TAVR device. | Figure 2 |
5. Simulate a “virtual valve” implantation using a simple cylinder to model the TAVR implant. Position it at the annular center, and rotate as needed to conform to bioprosthetic struts. | Figure 3 |
6. Measure VTC distances using the cylinder model. Confirm using simultaneous multiplanar reconstructions (short and long axes). | Figure 4 |
7. Measure VTSTJ distances and depict using simultaneous multiplanar reconstructions (short and long axes). | Figure 4 |
8. Assess target leaflet calcification. | Online Figure 3 |
9. Determine BASIlICA projection angles. Opposing annular markers overlap in side projections; annular markers are evenly spaced in en face projections. | Figure 5 |
10. Confounders: implantation characteristics and TAVR device. | Figure 6 |
11. Confounders: SAVR. | Online Figure 4 |
12. Confounders: anatomic. | Online Figure 5 |
SAVR = surgical aortic valve replacement; STJ = sinotubular junction; VTC = virtual valve-to-coronary; VTSTJ = virtual valve-to-sinus of Valsalva; other abbreviations as in Table 1.