Figure 1.

TAVI With Large Left Ventricular Thrombus

(A) Severely calcified aortic valve stenosis accompanied by a large left ventricular (LV) thrombus. (B) Aortic valve gradients measured before transcatheter aortic valve implantation (TAVI). (C) Computed tomography scan of the spatial relation of the aorta ascendens, the native aortic valve, the left ventricular outflow tract and the left ventricular thrombus (arrows). (D) Implantation of the protection devices Sentinel (Boston Scientific, Natick, Massachusetts) and FilterWire EZ (Boston Scientific) in the brachiocephalic trunk and the left common carotid artery and left vertebral artery, respectively. (E) Fluoroscopy of the expanded Edwards Sapien 3 prosthesis (Edwards Lifesciences, Irvine, California). (F) Transesophageal visualization of the transcatheter aortic valve implantation guidewire during the procedure. ACC = arteria carotis communis; MPG = mean pressure gradient; Vmax = maximum aortic velocity.