Mechanisms and prediction of aortic regurgitation after TAVI.

It has been demonstrated that moderate to severe paravalvular leak (PVL) after transcatheter aortic valve implantation (TAVI) procedures are related to impaired long-term prognosis. Anatomical and procedural factors influence the frequency and severity of PVL. Anatomical predictors of this complication are: annulus dimensions and shape, calcium distribution, angle between the ascending aorta axis and the left ventricular outflow tract (LVOT-AO). Procedural predictors: prosthesis-size-annulus mismatch, valve depth deployment and the acquired experience of the centre. An effort has to be made to optimise valve sizing and deployment.