case_images: PMC11804246_01
case_images: Aorto-mitral angle was measured 65/294  on multiplanar cardiac-gated computed tomography.
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case_images: Further pre-procedural evaluation included computed tomography-guided assessment of septal bulging, the aorto-mitral angle, and mitral valve size, along with estimation of the neo-LVOT area (Figures 1-3).
case_images: Assessment of mitral valve area for transcatheter mitral valve replacement on multiplanar cardiac-gated computed tomography.
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case_images: Further pre-procedural evaluation included computed tomography-guided assessment of septal bulging, the aorto-mitral angle, and mitral valve size, along with estimation of the neo-LVOT area (Figures 1-3).
case_images: Virtual estimation of neo-left ventricular outflow tract area for the Edwards SAPIEN 3 valve on multiplanar cardiac-gated computed tomography.
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case_images: Further pre-procedural evaluation included computed tomography-guided assessment of septal bulging, the aorto-mitral angle, and mitral valve size, along with estimation of the neo-LVOT area (Figures 1-3).
case_images: Stiff wire positioned at the posterolateral aspect of the left atrium, aligning the Edwards valve with the mitral annulus.
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case_images: The SAPIEN valve was then advanced and successfully deployed in the mitral position (Figure 4).
case_images: Doppler echocardiographic measured maximal gradient of 28 mmHg in the left ventricular outflow tract after the kissing balloon manoeuvre.
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case_images: Since these gradients were above acceptable levels, a kissing balloon manoeuvre was performed to alleviate the LVOT obstruction (see Supplementary material online, Video S1), resulting in a reduction of the LVOT peak gradient to 28 mmHg (Figure 5).