IntraCardiac Echocardiography-Guided Leaflet Modification for Coronary Protection Prior to Transcatheter Valve-in-Valve Replacement

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Abstract
A 79-year-old man with a failed 25-mm CE Magna Ease 3300 surgical prosthesis and of high re-operative surgical risk (STS 8%) presented with dyspnea, NYHA III. Cardiac computed tomography angiography revealed anatomy that was high risk for coronary occlusion with a short right coronary artery height of 6 mm and a valve-to-coronary distance of 2 mm. Clinical Images from Journal of Invasive Cardiology. Intracardiac echocardiography (ICE) leaflet modification valve-in-valve Transcatheter aortic valve replacement

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