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Valvular leak mechanisms. Incomplete valve adherence is due to prosthesis-patient mismatch or to incorrect site of implantation, resulting in large paravalvular leak (left panel); asymmetrical coverage of native aortic root may be due to incomplete prosthesis expansion because of remaining material of the native valve (mid panel). In right panel is shown an intra-valvular leak secondary to inappropriate overexpansion of the valve.
