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Mitral Valve Replacement With Sapien 3 Transcatheter Valve in Severe Mitral Annular Calcification Marek Polomsky, MD, Konstantinos P. Koulogiannis, MD, Robert M. Kipperman, MD, Barry M. Cohen, MD, Christopher J. Magovern, MD, James P. Slater, MD, Steve Xydas, MD, Leo Marcoff, MD, John M. Brown, MD The Annals of Thoracic Surgery Volume 103, Issue 1, Pages e57-e59 (January 2017) DOI: 10.1016/j.athoracsur.2016.06.105 Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Preoperative transthoracic echocardiographic image demonstrating mitral stenosis with severe mitral annular calcification. The Annals of Thoracic Surgery 2017 103, e57-e59DOI: (10.1016/j.athoracsur.2016.06.105) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Intraoperative views demonstrating (A) 26-mm True Balloon sizing through mitral annulus, (B) balloon expansion of 29-mm Sapien 3 valve, and (C) fully deployed 29-mm Sapien 3 valve (arrow). The Annals of Thoracic Surgery 2017 103, e57-e59DOI: (10.1016/j.athoracsur.2016.06.105) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Postoperative (A) two-dimensional and (B) three-dimensional transesophageal echocardiographic images demonstrating well-seated 29-mm Sapien 3 valve without any paravalvular leaks. The Annals of Thoracic Surgery 2017 103, e57-e59DOI: (10.1016/j.athoracsur.2016.06.105) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions