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In Reply We do not share the concerns of Dr Barbanti and colleagues or of Dr Reardon about the use of angiography as the primary tool for assessment of aortic regurgitation after TAVR in the CHOICE trial. Aortic regurgitation after TAVR is commonly paravalvular. These paravalvular jets are usually eccentric with crescentic, irregular orifices and may become entrained along the left ventricular wall, altering their appearance and the perception of severity, particularly with echocardiography.
Abdel-Wahab M, Mehilli J, Richardt G. Bioprosthetic Valves for Transcatheter Aortic Valve Replacement—Reply. JAMA. 2014;312(8):845-846. doi:10.1001/jama.2014.8375