Transcatheter aortic valve implantation (TAVI) for severe, isolated native aortic regurgitation is technically challenging because transcatheter valves developed for aortic stenosis are used off-label. The main problem is the lack of calcification of the valve tips, which complicates the anchoring of the implant and increases the risk of failure of the procedure. Another complication is the frequent presence of bicuspid valve anatomy, which makes correct valve placement difficult. Registry studies have reported high rates of valve embolization ranging from 6.4–15% and paravalvular regurgitation around 10%. These complications limit the wider use of TAVI in patients with native aortic regurgitation. The results suggest the need for specific valves or techniques for this indication, as current devices are optimized for aortic stenosis. However, TAVI is commonly and successfully used in patients with severe aortic stenosis, especially in those at high surgical risk[1][2].