Imaging and quantification of aortic regurgitation after TAVI

During the last decade, transcatheter aortic valve implantation (TAVI) techniques have evolved rapidly providing several systems that conform to a broad spectrum of aortic valve annulus sizes, developing new delivery systems that provide an alternative to patients with difficult vascular access and permitting more controlled and accurate prosthesis deployment that result in improved procedural outcomes. However, residual aortic regurgitation (AR) (paravalvular or transvalvular) remains a recurrent observation and patients with moderate or severe AR have a reduced mid-term prognosis Therefore, postprocedural AR should be carefully and accurately evaluated in order to decide whether additional procedures such as re-ballooning or valve-in-valve are needed to reduce AR severity, and changes in AR at follow-up should be monitored. In the current review, the role of cardiac imaging to understand the mechanism underlying AR after TAVI and to quantify the severity of AR will be discussed.