Could ultrasound replace X-Rays in heart valve surgery?

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * 1\. Patients aged 70 years or older with obvious clinical symptoms or a left ventricular ejection fraction less than 50% due to severe aortic valve stenosis (aortic valve orifice area \< 1.0 cm² or peak velocity ≥ 4.0 m/s or mean transvalvular pressure ≥ 40 mmHg); or patients with obvious clinical symptoms of low blood flow and low pressure difference aortic valve stenosis (effective aortic valve orifice area \< 1.0 cm², mean transvalvular pressure difference \< 40 mmHg, left ventricular ejection fraction \< 50%, stroke volume index \< 35 ml/m², and diagnosed as true severe aortic valve stenosis by dobutamine stress test); * 2\. Patients aged 65 years ≤ age \< 70 years with severe aortic stenosis who have surgical contraindications or high risks, or have other risk factors such as post-chest radiotherapy, liver failure, diffuse severe aortic calcification, extreme weakness, etc., or patients refuse to undergo routine open-chest surgery; * 3\. The patient's anatomical structure is suitable for TAVR and can tolerate transesophageal ultrasound; * 4\. The patient has signed the informed consent form and is willing to participate in this study. Exclusion Criteria: * 1\. Imaging (ultrasound and/or CT and/or MRI) confirmed a lesion, thrombus or calculus in the left ventricle; * 2\. Severe obstruction of the left ventricular outflow tract; * 3\. Severe right ventricular dysfunction; * 4\. Acute myocardial infarction within 30 days before the procedure; * 5\. Active endocarditis history within 180 days before the procedure; * 6\. Inappropriate aortic root anatomy (such as combined aortic dissection, excessive aortic annulus, risk of coronary artery occlusion, etc.); * 7\. Severe calcification and distortion of the surgical approach; * 8\. Left ventricular ejection fraction less than 20%; * 9\. Other cardiac diseases that require concurrent treatment (such as severe mitral regurgitation, atrial fibrillation, etc.); * 10\. History of stroke or transient ischemic attack within 90 days before the procedure; * 11\. Liver cirrhosis or active liver disease; * 12\. Renal insufficiency (creatinine clearance rate \< 30 mL/min) and/or undergoing renal replacement therapy; * 13\. Unable to tolerate anticoagulation therapy during or after the procedure; * 14\. Participating in other drug or device research; * 15\. Any emergency or surgical operation within 30 days before the procedure; * 16\. Other severe comorbidities, even if the valve stenosis is corrected, the expected life expectancy is less than 1 year; * 17\. Other conditions deemed unsuitable for TAVR surgery by the cardiac team.