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Transcatheter aortic valve implantation (TAVI) has undeniably revolutionised the field of interventional cardiology regarding the treatment of aortic stenosis (AS). With promising outcomes from the recently published PARTNER 2 trial (1), involving patients at intermediate risk for surgical treatment, further growth of an already rapidly expanding field is expected. Echocardiography has a pivotal role in transcatheter therapies from the early steps when the clinical diagnosis of a valvular disease is made to the postprocedural long-term follow-up. Although the role of transoesophageal echocardiography (TOE) for either pre-procedural planning or intraoperative guidance in TAVI has been the subject of several reviews and debates, the role of the older member of the family, transthoracic echocardiography (TTE), has not been given the attention it deserves. In this issue of Echo Research and Practice, Fryearson and coworkers review the role of TTE before and following TAVI and discuss as how it helps inform clinical decision-making in TAVI (2).

The old and the new: the pivotal role of TTE in TAVI