Post-dilating transcatheter heart valves.

In this issue of JACC: Cardiovascular Interventions, Nombella-Franco and the Quebec Heart and Lung Institute (1) report their experience with balloon post-dilation in patients with residual paravalvular aortic regurgitation after transcatheter heart valve (THV) implantation. Paravalvular regurgitation grade 2 was documented by transesophageal echocardiography in approximately one-third of their 211 patients. Post-dilation reduced regurgitation by 1 grade in the majority (71%), consistent with the early experience of our group in which paravalvular regurgitation was reduced in 75% of patients undergoing THV post-dilation (2).