Prosthetic Valve Size Selection Protocol

Theoretical prosthesis size selection was based on the annular measurements assessed in the 20% phase (max-systole) and 70% phase reconstruction (end-diastole) on the retrospectively ECG-gated scan[6 (link), 10 (link), 11 (link)], and from the non-ECG-synchronized scan. To estimate the theoretical prosthesis size, industry guidelines were used (S1 Appendix) for the balloon-expandable (ESV; Edwards Sapien 3, Edwards Lifesciences Corp, Irvine, CA, USA) and for the self-expandable trans-catheter aortic valve (MCV; CoreValve Evolut R, Medtronic, Minneapolis, MN, USA). The ESV-guideline uses the annular area and D_A for prosthesis sizing whilst the MCV-guideline uses the annular diameter and perimeter. MCV-guidelines define the perimeter as: annulus diameter x π. Prosthesis sizing was done for both the measured perimeter and for the calculated perimeter (calculated-perimeter).