Assessing the risk of leaflet motion abnormality following transcatheter aortic valve implantation

Leaflet motion abnormalities are a relatively new entity in the field of transcatheter aortic valve implantation and are associated with a range of different conditions, the extreme being prosthetic valve dysfunction with high gradients or central regurgitation and possibly early thrombotic degeneration. Another extreme condition is the incidental finding of leaflet thickening, but with normal transvalvular gradients. Transthoracic echocardiography is a useful screening tool for the detection of symptomatic thrombosis, but it has limited use in the detection of subclinical thrombosis and/or motion abnormalities alone. We, hereby, discuss the evidence for the potential screening process and subsequent management of those conditions associated with the leaflet motion abnormalities.