Toolbox: Catheter Selection
- The self-expanding valve has a concave central portion (measuring 20 mm to 24 mm) which is narrower than native aortic root dimensions.
- Smaller catheters: JL3.5 (femoral approach) or a JL3 (radial approach) for selective left coronary engagement; a JR4 can also been used to troubleshoot the narrow waist and engage the left coronary artery.
Catheter selection for coronary angiography does not need to be modified significantly in the presence of a balloon-expandable valves. The catheters used for routine angiography (JL4 and JR4) are usually suitable for selective coronary engagement in the presence of balloon-expandable valves. Selective engagement with first line catheters is usually feasible even in cases where the valve frame extends above the coronary ostia