Hasan Jilaihawi et al. JIMG 2016;9:1145-1158 BAV TAVR Using Early and Next Generation Balloon-Expandable Prostheses (A) Sapien in an angulated root with non-raphe type BAV morphology. The short device height is poorly suited to the tall sinus anatomy and makes positioning in the native annulus (dashed line) particularly challenging. No PAR was observed. (B) Sapien-3 expanded in a calcified raphe type BAV morphology. The device is constrained at the mid SOV level by at an area of lucency that represents a calcified raphe between the left and right coronary sinuses (arrow). No PAR was observed. A new permanent pacemaker was required. Abbreviations as in Figures 1, 2, and 3. Hasan Jilaihawi et al. JIMG 2016;9:1145-1158 American College of Cardiology Foundation