fig3

Figure 3. Coronary protection with “chimney stenting” technique. Valve-in-valve procedure for a patient at high risk for coronary obstruction (low-lying coronary ostia and narrow sinuses). (A) Left coronary ostium was engaged and a wire and stent (yellow star) placed distally in the artery prior to valve deployment. (B) Following valve deployment, the stent was retracted and (C) implanted adjacent to the transcatheter valve. (D) The CT reconstruction image shows half the stent placed in the ostium and the other half protruding into the aorta.