**6. Conclusion**

Symptomatic AR carries a high mortality if left untreated. Patients at high or prohibitive surgical risk may be candidates for off-label TAVR on a case-by-case basis, as determined by the heart team. The off-label use of TAVR for AR has shown promising results from registry data. The challenges of TAVR for AR include improper valvular seal, PVL, valve embolization, and malalignment or malposition of the bioprosthetic valve due to lack of calcification and enlarged aortic annuli. Valve oversizing can help overcome technical issues but carries the risk of annular rupture. The newer generation transcatheter valves designed especially for the treatment of pure native AR are undergoing clinical trials. Until the results of randomized clinical trials are available, careful selection of patients is paramount to procedural and clinical success.
