Infolding of a self-expanding bioprosthesis due to loss of nitinol memory during transcatheter aortic valve implantation

Figure 1. Computed tomography of native aortic annulus and serial fluoroscopic images of transcatheter aortic valve implantation procedure. A) Computed tomography of aortic annulus shows calcium at clock positions 2 and 6. B) In vitro fluoroscopic confirmation of the appropriately loaded 34 mm Evolut R valve system. C) Infolding of the valve frame is shown in between the arrows (dotted dark blue area in the cartoon inset). D) Underexpanded valve frame after complete release of the valve (dotted dark blue area in the cartoon inset). E) Balloon dilatation of the underexpanded valve frame with a 25 mm × 5 cm Z-MED II balloon. F) ...