The timing of pe- riodic follow-up imaging is based on the type of valve intervention. Table 12. Timing of Periodic Imaging After Valve Intervention Valve Intervention Imaging Follow-Up* Minimal Imaging Frequency Location Mechanical valve (surgical) Baseline Primary Valve Center Bioprosthetic valve (surgical) Baseline, 5 and 10 y after surgery, and then annually Primary Valve Center Bioprosthetic valve (transcatheter) Baseline and then annually Primary Valve Center Mitral valve repair (surgical) Baseline, 1 y, and then every 2 to 3 y Primary Valve Center Mitral valve repair (transcatheter) Baseline and then annually Comprehensive Valve Center Bicuspid aortic valve disease Continued post-AVR monitoring of aortic size if aortic diameter is 4.0 cm at time of AVR, as detailed in Section 5.1 Primary Valve Center *Initial postprocedural TTE is recommended for all patients, ideally 1 to 3 months after the procedure. Annual clinical follow-up is recommended annually for all patients after valve intervention at a Primary or Comprehensive Valve Center. Repeat imaging is appropriate at shorter follow-up intervals for changing signs or symptoms, during pregnancy, and to monitor residual or concurrent cardiac dysfunction. Imaging may be done more frequently in patients with bioprosthetic surgical valves if there are risk factors for early valve degeneration (eg, younger age, renal failure, diabetes). AVR indicates aortic valve replacement; and TTE, transthoracic echocardiography. CLINICAL STATEMENTS AND GUIDELINES Recommendation-Specific Supportive Text 1. In patients who have had a valve intervention, most cardiologists continue to see patients for a clinical history and physical examination at annual intervals, or more frequently if needed for symptoms or concurrent conditions. A baseline TTE study is recommended after all valve inter- ventions, including replacement with a prosthetic valve (see Section 11.1). 