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BACKGROUND Advancement of transcatheter aortic valve replacement (TAVR) and its long-term outcomes is warranted as it expands to a low-risk population. Procedural optimization using commissural alignment (CA) and the cusp-overlap technique have recently been suggested, especially for supra-annular self-expanding valves. The Evolut valve (EV) has two markers to guide valve position and orientation: the hat-marker and the flush port.
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