Prosthetic heart valve having identifiers for aiding in radiographic positioning

A method comprising the steps of:

• providing a valve prosthesis that includes a prosthetic heart valve and at least one commissural post formed of a material, the prosthetic heart valve being coupled to the at least one commissural post, the at least one commissural post being provided with a radiographic identifier that is shaped to be reflection-asymmetric about an axis of the at least one commissural post that is generally parallel with the central longitudinal axis of the valve prosthesis wherein the at least one commissural post is shaped to define an opening through a thickness of the material of the at least one commissural post such that the opening does not include the material of the at least one commissural post, the opening defining an entirety of the radiographic identifier such that the radiographic identifier is bounded by the material of the at least one commissural post and is void of the material of the at least one commissural post, the opening having a reflection-asymmetric shape about the axis of the at least one commissural post, and even further wherein a radiopacity of the valve prosthesis at the radiographic identifier is less than a radiopacity of the material of the at least one commissural post;
• while the valve prosthesis is in the collapsed position, placing, via a blood vessel of the subject, the valve prosthesis at least partially in a heart of a subject in a vicinity of a native heart valve having native commissures;
• generating a fluoroscopic image of the native commissures and valve prosthesis;
• and
• rotationally aligning the radiographic identifier visible in the image with at least one of the native commissures;
• wherein rotationally aligning comprises:
• rotating the valve prosthesis;
• observing whether the radiographic identifier appears to move in the image in the same direction that the valve prosthesis is rotated, or in an opposite direction;
• and
• if the radiographic identifier appears to move in the image in the opposite direction, rotating the valve prosthesis to correct a rotational alignment of the valve prosthesis.