Placement of a Self-Expanding Transcatheter Aortic Valve Prosthesis in the Presence of Aortic Arch Angulation

An 83-year-old man with symptomatic severe aortic valve stenosis with severe ventricular dysfunction underwent valvuloplasty with a 25-mm NuCLEUS-X balloon (B. Braun Interventional Systems) and percutaneous coronary intervention of the left main and circumflex arteries (left anterior descending artery presented a chronic total occlusion without viability of this territory) before being referred for transcatheter aortic valve replacement.