Feasibility of Valve-in-Root Transcatheter Aortic Valve Implantation in 363 Patients After Aortic Root Replacement and Repair

CT scans of patients after biological root replacement and root repair were assessed with the 3mensio Software (Aortic valve package, 3mensio 10.1, Pie Medical Imaging. Before carrying out the measurements, markers for alignment of the aortic root and ascending aorta were placed manually. The annular area was measured for both groups. In patients after biological root replacement the area of the annulus was defined as the ring of the initial aortic valve prosthesis. Coronary buttons were measured at their lowest and highest point to define partial or full position below the valve level and the general button size. For assessment of the annular-to-coronary distance, the lower edge of the coronary button was chosen. VTC was assessed after root replacement in patients who had at least one coronary partially under the level of the valve. For this measurement a virtually inserted valve was placed in the bioprosthetic frame.