**2. Etiopathogenesis**

PVL after SVR are several co-contributing factors, related to the anatomy of the valve, the surgical technique, the status of the patient, and/or to the surgeon's experience [6], they are depicted in **Table 1**. In TAVR, massive and asymmetrical calcifications and elliptical annulus shape as the main anatomical contributors, insufficient sizing and insufficient depth implantation as procedural predictors and functional c.

Lass and low left ventricular ejection fraction (LVEF) as patient condition factors [7, 8], the experience of the operator remains important to consider. Infective endocarditis (IE) is a main cause of valve disinsertion and can also be a consequence of a mechanical disinsertion with a secondary bacterial infection [9, 10].
