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Applied Anatomy: Height of Valve Skirt

  • The skirt height of self-expanding valve is 13-14 mm which rises up to 26 mm above the inflow at the level of three commissural posts.
  • If the sealing skirt is overlying the coronary ostium, selective coronary engagement cannot be done co-axially from a diamond in front of the opening. Instead engagement will occur from a diamond above the ostium, and a straighter catheter with a short-tip such as a JR4 could be used even for left main engagement.
  • The balloon expandable valve has both an inner and outer skirt. The outer skirt ranges between 5.2mm to 8.1mm which will rise between 13.1mm to 19.1mm above the inflow at the level of three commissural posts.
  • If the sealing skirt is overlaying the coronary ostium, selective coronary engagement can be done co-axially from a diamond in front of the opening. Instead engagement will occur from a diamond above the ostium, and a straighter catheter with a short tip such as a JR4 could be used even for left main engagement.
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