“… 2 The overriding concern associated with the TC of PVLs includes stroke, vascular complications, major bleeding, AKI, pulmonary infection, procedural‐related mechanical valve dysfunction, coronary obstruction, residual PVL resulting in worsening hemolysis, and device embolization. 2 , 4 , 8 , 11 , 12 , 13 , 14 , 18 , 21 , 22 , 23 The main disadvantage of the TC is the higher incidence of PVL after the procedure compared with surgery (29.9 versus 4.5%; P <0.001). 11 In the present study, the incidence of moderate to severe residual PVL after index surgical treatment or TC was comparable with the literature, which varied from 4.5% to 50%.…”