Fig. 30

A 58-year-old male following TAVR with a 26-mm Edwards SAPIEN valve and severe paravalvular regurgitation. Coronal oblique MPR of an enhanced MDCT before TAVR (a) and coronal oblique thick MPR of an enhanced MDCT following TAVR (b). Key anatomic landmarks: Native aortic valve annulus plane (solid black arrow), left main coronary emanating from left coronary sinus of Valsalva (solid white arrow), sinotubular junction (dotted white arrow), Edwards SAPIEN valve (double-headed arrow) and mitral valve annular calcifications (*). Note very high positioning of the Edwards SAPIEN valve 100 % above the native aortic valve annulus in contradiction to the conventional recommendation to implant the device 50 % below and 50 % above native aortic valve annulus