The distance between the coronary ostium and the aortic annulus plane is also a matter of great concern for TAVI in small body size patients. Our previous study showed the distance between the left coronary ostium and the aortic annulus plane was shorter in the small body group.7 Rebeiro et al. reported on data from a multicentre registry, which showed that a lower-lying coronary ostium and a shallow sinus of valsalva were associated with coronary obstruction after TAVI.18 Prevention of coronary occlusion using, for example, coronary protection with prior wire placement into the coronary before valve implantation may be a valuable solution.19 In the registry data, the coronary obstruction rate was more than twice as high among patients who received a balloonexpandable valve than among those who received a self-expandable valve (0.81 % versus 0.34 %).9 A self-expandable valve system will be suitable for the small body patients with the risk of coronary obstruction, however, attention should be paid to the small size of sinus of valsalva with a potential risk of coronary obstruction.