Introduction

There is an expanding role for transcatheter heart valve (THV) interventions for native and prosthetic valve pathologies in which imaging plays a key role. The heart team discussion involving the interventional cardiologist, surgeon, imager and anesthesiologist has become the ideal model to strategize THV procedures. However, this concept is not limited to pre-procedure planning only, but includes a collaborative effort during and after the procedure. Both the interventional cardiologist and imager must speak a unified language. The interventional cardiologist should grasp the echocardiographic definitions of anatomy and severity, while the imager should be familiar with procedural steps. The team should also have complimentary roles during the procedure, synchronizing management of hemodynamics, pain and anticoagulation by anesthesia, preparation of the equipment by the nursing staff, positioning and detection of complications by the imager, and delivery and deployment of devices by the interventional cardiologist. It is imperative that teams develop a floor plan and workflow that includes all members. This harmony allows timely detection and prevention of complications. In this review, we focus on the common mitral and aortic THV procedural complications and the role of imaging to guide diagnosis and management.