This updated Heart Valve Collaboratory framework addresses the growing concern for transcatheter valve failure (TVF) following transcatheter aortic valve replacement (TAVR). With the increasing volume of redo TAV and surgical TAV explant, there is a critical need for standardized pathways and protocols for evaluating TVF using echocardiography and cardiac computed tomography angiography (CCTA). This document clarifies prior definitions of bioprosthetic valve deterioration (BVD) and bioprosthetic valve failure (BVF) in a practical, imaging directed context for TAVR. It discusses various imaging modalities for diagnosing TVF, including echocardiography, CCTA, cardiac magnetic resonance (CMR), and positron emission tomography / computed tomography (PET/CT). Recommendations are provided on the systematic imaging for (i) follow-up post-TAVR, (ii) procedural planning for redo TAV and (iii) post-redo TAV, emphasizing the importance of regular monitoring and the need for comprehensive imaging data to optimize patient outcomes in the lifetime management of aortic valve disease.

Editors
Editor-in-Chief
Harlan M. Krumholz, MD, SM, FACC 

CME Editor
Ragavendra R. Baliga, MD

Author
Jason Matos, MD

Important Dates
Date of Release: March 10, 2025
Term of Approval/Date of CME/MOC Expiration: March 9, 2026