Darren Mylotte1, MD; Haytham Makki1, MD; Nicolo Piazza2, MD, PhD
1. University Hospital Galway, Galway, Ireland; 2. McGill University Health Centre, Montreal, Quebec, Canada
“Trust not too much to appearances” - Virgil
Paravalvular aortic regurgitation (PAR) is an important determinant of outcome following transcatheter aortic valve implantation (TAVI); patients with significant PAR remain more symptomatic and have reduced life expectancy compared to those with little/no paravalvular leak1. Quantification of PAR, however, remains a considerable challenge despite the development of echocardiographic, angiographic, and haemodynamic assessment algorithms2. Two-dimensional echocardiography (2D-echo) is recommended to determine the location (trans- or paravalvular), mechanism, and severity of PAR2. By extension, 2D-echo determines the requirement for and likely success of additional bail-out interventions to treat significant PAR. Unfortunately, 2...