An 86-year-old woman with symptomatic severe aortic stenosis was referred to our center for transcatheter aortic valve implantation (TAVI). The patient suffered from permanent atrial fibrillation without intraventricular conduction delays ( Fig. 1 .A) and severe chronic kidney disease with an estimated glomerular filtration rate of 20 ml/min. Given the high risk of further kidney injury, the patient underwent a contrast-zero pre-TAVI computed tomography (CT), which demonstrated the feasibility of a transfemoral procedure ( Online Video 1 ), applying a previous described methodology [ ]. Aortic annulus perimeter was 76.7 mm with a perimeter-derived diameter of 24.4 mm ( Fig. 1 .B), whereas the mean sinus diameter was 31.7 mm. The valve was mildly calcified ( Fig. 1 .C).