Paravalvular regurgitation one year after transcatheter aortic valve implantation.
OBJECTIVE
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.
Sussex Cardiac Centre, Brighton and Sussex University Hospitals, Brighton, BN2 5BE, United Kingdom. dr.r.rajani@gmail.com
Ronak
R
Rajani
Mitesh
M
Kakad
Muhammed Z
MZ
Khawaja
Lorraine
L
Lee
Rachael
R
James
Mrinal
M
Saha
David
D
Hildick-Smith
D000368:Aged; D000369:Aged, 80 and over; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D001705:Bioprosthesis; D002404:Catheterization; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation; D006439:Hemodynamics; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D011474:Prosthesis Design; D012720:Severity of Illness Index; D014463:Ultrasonography