PMC5352869_01
Composite image of a tortuous S-shaped aorta.
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fig1
During the preprocedure workup, he was found to have a very tortuous iliofemoral system, as well as a significant S-type bend in the descending aorta (Figures 1(a)-1(c), Video 1 (see supplementary Video 1 in the Supplementary Materials available online at https://doi.org/10.1155/2017/2936513)). Amplatz guide catheter was placed into the proximal descending aorta and two Lunderquist (Cook Medical, Bloomington, Indiana) wires were sequentially placed into the aortic arch through this catheter. A pull on the catheter was required to straighten the descending aorta (Figure 1(d), Video 2). After switching over to a third Lunderquist wire, the valve was correctly aligned (Figure 1(e)) and deployed under burst pacing (Figure 1(f), Video 4).