Figure 5. Histological analysis of the S3 leaflets according to timing of fracture.

Histological appearance of S3 leaflets when not fractured (A), when fracture is performed before ViV (first) (B) or after ViV (C) showing the whole leaflet length and representative positive pixel count analysis in high resolution inset for A-C. Quantification of leaflet thickness (D) and leaflet density by positive pixel counting for the entire leaflet thickness (E), and segmented into aortic and ventricular aspects of the leaflet (F). BVF: bioprosthetic valve fracture; S3: SAPIEN 3; ViV: valve-in-valve