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Fig. 1 | European Journal of Medical Research

Fig. 1

From: Transcatheter aortic valve implantation with a mechanically expandable prosthesis: a learning experience for permanent pacemaker implantation rate reduction

Fig. 1

LOTUS implantation technique. a Initial position of LOTUS delivery system with marker pigtail placed in non-coronary cusp (nadir point) and distal end of valve nitinol frame depicted in projection of the annular plane. b Early stage of valve unsheathing with the valve nitinol frame reaching annular contact. Continuous backward tension on the delivery system helps maintaining a “high position” of the frame in respect to the native annulus. c The LOTUS nitinol frame starts to shorten and progressive “lay-over” of the delivery system with the main axis of the native aorta is achieved by applying forward pressure. d Final angiography demonstrating high annular position of the LOTUS valve with perfect annular sealing

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