Figure 1: Severe Aortic Stenosis and Severe Organic Mitral Regurgitation.

Example of a 78-year-old male patient with symptomatic severe low ejection fraction, low- gradient (LEF-LG) aortic stenosis (AS) and concomitant severe organic mitral regurgitation (MR) who underwent transcatheter aortic valve implantation (TAVI) with a 29 mm Edwards SAPIEN 3 bioprosthesis A. There was a minimal paravalvular aortic regurgitation following TAVI on transthoracic echocardiography; B. Colour flow mapping demonstrated severe MR persisting after TAVI; C. The severity was confirmed using quantitatively (effective regurgitant orifice area [EROA] = 50mm² and regurgitant volume = 103 mL); D. A recent study reported that patients with LEF-LG) severe AS and moderate to severe MR have a three-fold higher mortality rate as compared with similar patients with mild or less MR after TAVI.[12] Organic MR (as shown in the present example) is less likely to improve after TAVI as compared with functional MR.[12]