Commissural alignment with the novel Hydra transcatheter heart valve during aortic valve replacement

  An 83-year-old gentleman with severe aortic valve stenosis was deemed eligible for transfemoral transcatheter aortic valve replacement (TAVR) after a Heart Team evaluation. Cardiac computed tomography showed severe calcification of the native aortic valve leaflets (Figure 1A1, Figure 1A2). A 30 mm self-expanding Hydra (Sahajanand Medical Technologies) transcatheter heart valve (THV) was chosen (Moving image 1). This novel supra-annular THV has a nitinol frame with large stent cells (≥15 Fr) and a three-tentacle design at the stent outflow. Bovine pericardium leaflets are attached to the stent by three commissures, placed between the three tentacles. Six radiopaque markers, aligned three by three ...