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Updated: Sep 18, 2025

Mechanical Expansion of Steel Tubing as a Solution to Leaky Wellbores
Published on: November 20, 2014
Management of TAVI Underexpansion with Self-Expanding Valves: A Practical Approach
Rene Hameau1,2, Marco B Ancona1, Vittorio Romano1
1Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
Abstract:
Underexpansion of a self-expanding transcatheter aortic valve (TAVI) is a critical issue that can negatively impact long-term outcomes, including paravalvular leak, valve thrombosis, and increased mortality. This paper provides a comprehensive review of the pathophysiology and consequences of such complications, including three primary mechanisms: (1) infolding, (2) incorrect site of crossing and (3) true underexpansion. It also discusses strategies to address these challenges, including pre-procedural planning and procedural techniques to ensure proper valve deployment and expansion. Mitigating these issues is essential to improving both immediate and long-term outcomes in TAVI patients.
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