Fig. 12

Sequence of images describing the step-by-step process of creating a plane that precisely corresponds to the aortic annulus [17, 24]. a Thin-sliced axial reconstructions (0.625 mm for GE and 0.5 mm for Toshiba) are used to create standard coronal, sagittal and transverse plane reconstructions. b Coronal plane reference line is rotated to bring the former axial plane as close as possible to the plane of the valve. c The reference line in the coronal image that controls the former axial plane is moved up and down to identify the lowest insertion point of the right coronary cusp, and the former axial plane is positioned exactly at the level of the right cusp insertion point. d The reference line in the formerly axial plane is rotated such that the line that controls the former sagittal plane crosses the lowest insertion point of the non-coronary cusp (located approximately at the 8 o’clock position, *). e Manipulation with the former sagittal plane, currently showing the lowest insertion of the right and non-coronary cusp. On this plane, the reference line of the former axial plane should be rotated until it crosses the two insertion points. f On the former coronal plane the reference line of the former axial plane is rotated until the lowest point of the left coronary cusp appears on the formerly axial plane window. At this point the formerly axial plane is now rotated to represent the correct orientation and level of the aortic valvular plane. This image should be used to provide all the precise pertinent measurements