Aortic Regurgitation Index ratio is a strong predictor of one-year mortality after transcatheter aortic valve implantation using self-expanding devices.

Grading PVL at the time of TAVI deployment is challenging. Per-procedural invasive hemodynamic measurements could serve to optimize PVL grading and predict outcome after TAVI. The aim of this study was to compare hemodynamic measures of paravalvular leak and their prognostic relevance in self-expanding TAVI devices. Between December 2008 and December 2017 consecutive patients treated for severe symptomatic aortic valve stenosis with self-expanding devices were prospectively studied. Peri-procedural hemodynamic measurements, echocardiographic data as well as clinical follow-up according to VARC-2 criteria were prospectively collected. Diastolic delta (DD), heart rate adjusted diastolic delta (HR-DD), aortic regurgitation index (ARI) and ARI ratio were calculated and assessed for their association with one-year mortality. A total of 651 patients was studied. Moderate or severe paravalvular leakage was found in 4.8% of patients. ARI ratio