“…In 2012, the PARTNER trial presented data which showed comparable results of the first generation Edwards Sapien THV (Edwards Lifesciences Co., Irvine, CA, USA) and SAVR for severe aortic stenosis in high-risk patients regarding mortality, reduction in symptoms and valve hemodynamics [ 3 ]. Despite introduction of a wide variety of THVs into the medical sector, with largely favorable results [ 4 , 5 ] and improved delivery systems, imaging or access site techniques [ 6 – 8 ], one major problem of THVs remains paravalvular leakage (PVL). PVL has a significantly higher incidence following TAVI compared to SAVR and leads to increased mortality if grade of PVL is ≥ moderate (2-year mortality of 30 % in mild aortic regurgitation, 40 % in moderate, 3-year mortality of 60 % in severe aortic regurgitation) [ 9 , 10 ].…”