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Figure 4 Early TEE Assessment of Paravalvular AR After PHV Deployment

Early assessment of paravalvular AR is an indicator of procedural success but may also help to determine the need for subsequent balloon dilatation of the PHV. (A) Transesophageal echocardiography showing mild paravalvular regurgitation (red arrow) in the long-axis view. (B) TEE showing mild paravalvular regurgitation (red arrow) in the short-axis view. It is the short-axis view that most reliably distinguishes paravalvular AR from transvalvular AR, especially if the vena contracta of the paravalvular jet is out of plane in the long-axis view. Online Video 5 shows a short-axis view of AR following PHV deployment. Paravalvular AR is seen at the 3 o'clock position along with a smaller jet of transvalvular AR. AR = aortic regurgitation; other abbreviations as in Figure 1.