Anatomical morphology of the aortic valve in Chinese aortic stenosis patients and clinical results after downsize strategy of transcatheter aortic valve replacement

Figures

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  Figure 1. Calcium assessment and leaflets measurement of aortic stenosis patients. (A) The aortic root was divided into five specific regions. LVOT region: from 6 mm below the annular plane to 2 mm below the annular plane; Annulus region: from 2 mm below the annular plane to 2 mm superior to the annular plane; Lower leaflet region: from 2 mm superior to the annular plane to 6 mm superior to the annular plane; Mid leaflet region: from 6 mm superior to the annular plane to 10 mm superior to the annular plane; Upper leaflet region: from 10 mm superior to the annular plane to the sinotubular junction level; (B) Calcium quantification by leaflet sector: Purple, yellow and blue represent the left, right and none coronary leaflet sectors respectively; (C) Leaflets thickness and fusion between measurements for TAV and Type-1 BiAV: Length A (red line): Commissure to opposite sinus measurement; Length B (yellow imaginary line): Fusion length between leaflets (measured as commissure to the very point the leaflet separated); Length C (blue imaginary line): Thickness of leaflet (measured as the high-density or low-density tissue between the sinus of Valsalva and aortic valve orifice); (D) Leaflets…

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  Figure 2. Calcium volume scores at different levels of the aortic root in aortic stenosis patients. (A) Volume scores in all patients. (B) Volume scores in patients with TriAV. (C) Volume scores in patients with BiAV. (D) Volume scores in patients with Sievers type-1 bicuspid aortic valve. (E) Volume scores in patients with Sievers type-0 bicuspid aortic valve. BiAV: Bicuspid aortic valve; LVOT: Left ventricular outflow tract; TriAV: Tricuspid aortic valve.

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  Figure 3. Fusion between leaflets of aortic stenosis patients. BiAV: Bicuspid aortic valve; TriAV: Tricuspid aortic valve; Type-1 BiAV: Sievers type-1 bicuspid aortic valve; Type-0 BiAV: Sievers type-0 bicuspid aortic valve.

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  Figure 4. Echocardiographic findings of aortic stenosis patients. (A) Mean pressure gradients from baseline to one year for patients in annulus sizing and downsize groups. (B) Paravalvular aortic regurgitation incidence. The incidence of paravalvular aortic regurgitation in the downsize versus annulus sizing groups is shown at various follow-up time points. TAVR: Transcatheter aortic valve replacement.