Procedural Techniques for the Management of Severe Transvalvular and Paravalvular Aortic Regurgitation During TAVR.

Aortic regurgitation (AR) after transcatheter aortic valve replacement (TAVR) is associated with an increased risk of mortality. In severe cases, abrupt hemodynamic changes may occur with a sudden increase in left ventricular end-diastolic pressure that results in frank pulmonary edema, hypoxia, and cardiogenic shock. Here, the case is reported of a patient who developed severe AR immediately after valve deployment that led to severe hemodynamic compromise. The procedural techniques necessary for the immediate management of severe transvalvular and paravalvular AR are described.