[Comment] TAVI for native aortic regurgitation

Transcatheter aortic valve implantation (TAVI) for severe, isolated, native aortic regurgitation has been challenging with use of transcatheter heart valves designed for aortic stenosis (off-label use). In several registry studies in which transcatheter heart valves were used to treat aortic regurgitation, the main concerns with this approach were the lack of leaflet calcification (which hinders valve anchoring and increases the risk of procedural failure), the frequent bicuspid valve anatomy, high rates of valve embolisation (6·4–15%), and paravalvular regurgitation (10%).