FIGURE 1. Baseline CT and Key Procedure Steps to Set Up CATHEDRAL.
(A and B) Prolapsing left leaflet and coronary obstruction risk by long leaflet. (C) Aortography, severe AR. (D) Prolapsing leaflet (asterisk) traversed with AstatoXS20 wire. (E) Flying V across leaflet. (F) 12-F sheath and guider with snare lasso advanced over Flying V and energized. (F) Inset: The snare is advanced over the “corner” of the leaflet torn from the commissure. With traction and rotation of the Flying V (red lines), the remaining part of the leaflet can be pulled into the snare. Dashed blue lines indicate the leaflet.
AR = aortic regurgitation; CT = computed tomography; CATHEDRAL = Catheter electrosurgical debulking and removal.