Paravalvular leak after transcatheter aortic valve implantation: trading one disease for another?

Paravalvular leak is a common complication occurring after transcatheter aortic valve implantation and is associated with at least a 2-fold increase in 30-day and 1-year mortality risk. In high-risk, inoperable patients with severe aortic stenosis, paravalvular leak may even negate the survival benefit of transcatheter aortic valve implantation. This editorial reviews the anatomy, pathophysiology and predictors of paravalvular leak and discusses preventative and therapeutic strategies to optimally treat this previously underappreciated complication.