Percutaneous pulmonary valve implantation guided by three-dimensional rotational angiography

Figures

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  Fig. 1. a. “Entire Heart” protocol b “Interrogation” protocol.

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  Fig. 2. Three-dimensional angiography in bifurcation stenting. Stents in situ; EV3 max LD stents, RPA 36 mm stent on BIB balloon 16 × 30mm; strut opening to LPA and stent through strut to LPA: EV3 mega LD 36 mm on BIB 16 × 30mm (Y-technique) Post-dilatation stents with Atlas 16x20mm. PPVI with a Melody 22 mm valve was performed in a second procedure.

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  Fig. 3. Coronary compression not anticipated from pre-procedural CTA.

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  Fig. 4. “Interrogation protocol” shows an inflated balloon (blue) and high resolution calcified tissue in the RVOT (yellow). A close relation to the LCA is visible and high risk for CC was estimated in this patient. (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)

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  Fig. 5. Proximal left main compression during balloon inflation in the RVOT.

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  Fig. 6. Paravalvular leakage assessed with RVOT interrogation with a balloon (CBV Crystal Balt) and simultaneous contrast injection in the RVOT.

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  Fig. 7. a. Pre-procedural CTA with an MPA diameter of 25,3 mm. 7b. Unstable 30 × 40mm balloon in RVOT with passing of contrast (poorly visible in still frame).