Paravalvular regurgitation one year after transcatheter aortic valve implantation

Catheter Cardiovasc Interv. 2010 May 1;75(6):868-72. doi: 10.1002/ccd.22399.

Abstract

Objectives: The aim of this study was to assess the natural history of paravalvular regurgitation at 1 year in patients undergoing TAVI.

Background: The immediate incidence of paravalvular regurgitation is estimated to be between 65 and 85% following transcatheter aortic valve implantation (TAVI). There is limited data as to whether this deteriorates during follow-up.

Methods: Forty-six patients were recruited from a TAVI programme at our institute. All patients underwent an assessment of prosthetic valve function periprocedurally with aortography and immediately postprocedurally with transthoracic echocardiography. Twenty-one patients with a median age was 83 (66-91) years of whom 14 were male reached 1 year follow-up, 13 of whom were available for repeat transthoracic echocardiography.

Results: The incidence of paravalvular regurgitation immediately following TAVI was 86%. Of them 57% had < or = mild regurgitation and 29% had > mild regurgitation. At 1 year the incidence of paravalvular regurgitation was 77%. 54% had < or = mild regurgitation and 34% > mild regurgitation. No patient had severe regurgitation. The degree of regurgitation reduced in 6 (46%), stayed the same in 3 (23%), and increased in 4 (31%) of patients.

Conclusions: Patients undergoing TAVI have an immediate postprocedural risk of regurgitation of 86%. In the majority of cases the degree of paravalvular CoreValve regurgitation is mild, and remains stable in 70% of patients during medium term follow-up.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aortic Valve Insufficiency / diagnostic imaging
  • Aortic Valve Insufficiency / epidemiology*
  • Aortic Valve Insufficiency / etiology
  • Aortic Valve Insufficiency / physiopathology
  • Bioprosthesis
  • Catheterization
  • Female
  • Follow-Up Studies
  • Heart Valve Prosthesis Implantation*
  • Hemodynamics
  • Humans
  • Male
  • Postoperative Complications / epidemiology
  • Prosthesis Design
  • Severity of Illness Index
  • Ultrasonography