Paravalvular Regurgitation After Transcatheter Aortic Valve Replacement: Is the Problem Solved?

Interv Cardiol Clin. 2018 Oct;7(4):445-458. doi: 10.1016/j.iccl.2018.06.005. Epub 2018 Aug 14.

Abstract

Paravalvular regurgitation is a frequent complication after transcatheter aortic valve replacement and its association with worse outcomes depends on the degree of its severity. Despite substantial improvement in transcatheter heart valve design, sizing and implantation technique, moderate or severe paravalvular regurgitation still occurs in 2% to 7% of patients and is associated with a more than 2-fold increase in mortality. This review provides a state-of-the-art approach to (i) paravalvular regurgitation prevention by optimizing patient selection, valve sizing, and positioning and (ii) the detection, quantitation and management of paravalvular regurgitation during and after valve implantation.

Keywords: Aortic stenosis; Complication; Paravalvular aortic regurgitation; Transcatheter aortic valve replacement; Valve implantation.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Angiography
  • Aortic Valve / anatomy & histology
  • Aortic Valve / diagnostic imaging
  • Aortic Valve Insufficiency / epidemiology
  • Aortic Valve Insufficiency / etiology*
  • Aortic Valve Insufficiency / mortality
  • Aortic Valve Insufficiency / prevention & control
  • Aortic Valve Stenosis / complications
  • Aortic Valve Stenosis / surgery*
  • Biomarkers
  • Echocardiography, Transesophageal
  • Heart Valve Prosthesis
  • Heart Valve Prosthesis Implantation / adverse effects*
  • Humans
  • Magnetic Resonance Spectroscopy
  • Multidetector Computed Tomography
  • Patient Selection
  • Preoperative Period
  • Prosthesis Design
  • Risk Factors
  • Severity of Illness Index
  • Transcatheter Aortic Valve Replacement / adverse effects*
  • Transcatheter Aortic Valve Replacement / instrumentation
  • Ventricular Function, Left / physiology

Substances

  • Biomarkers