Canadian Journal of Cardiology

String sign and heart shape after 34-mm Evolut R valve implantation

Published:September 22, 2022DOI:


      An 83-year-old gentleman underwent transcatheter aortic valve replacement using a 34-mm Evolut R valve. Considering the residual mean gradient (19 mmHg) and the presence of the string sign, post-dilatation was performed. The infolding persisted on fluoroscopy but the final mean gradient was 9 mmHg. At 30-day follow-up, transeosophageal echocardiography and CT scan showed a heart-shaped prosthesis inflow. Follow-up at 3 years did not show any sign of early structural valve deterioration.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Canadian Journal of Cardiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Ancona M.B.
        • Beneduce A.
        • Romano V.
        • et al.
        Self-expanding transcatheter aortic valve infolding: Current evidence, diagnosis, and management.
        Catheter Cardiovasc Interv. 2021; 98: E299-E305