title: Aortic regurgitation after transcatheter aortic valve implantation of the Edwards SAPIEN ™ valve.
abstract: BACKGROUND
  Transcatheter aortic valve implantation (TAVI) is established as an attractive treatment option for high-risk patients with aortic valve stenosis. One concern is the high risk of prosthetic valve regurgitation. This study aimed to examine for potential preoperative risk factors for postprocedural transcatheter heart valve regurgitation and to quantify the risk, degree, and consequences of postprocedural regurgitation.
  
  
  METHODS
  100 consecutive patients who underwent femoral (n = 22) or transapical (n = 78) TAVI were retrospectively reviewed. Echocardiographic valve regurgitation and clinical parameters were analyzed over the first year after TAVI.
  
  
  RESULTS
  Seventy-five percent of all patients had prosthetic valve regurgitation. It was, however, only mild or absent in 64% of patients and did not require re-intervention in any of the patients in the series. The severity of the regurgitation appeared unchanged over the one-year follow-up period. Moderate to severe regurgitation was associated with significant yet stable dilatation of the left ventricle over one year and lesser NYHA class improvement three months after TAVI. Asymmetrical native valve calcification increased the risk of paravalvular regurgitation non-significantly.
  
  
  CONCLUSIONS
  Transcatheter heart valve regurgitation seems to be mild in the majority of cases and unchanged over a 12 months follow-up period. While affecting left ventricular dimensions in moderate or severe cases, we observed no obvious undesirable consequences of the prosthetic valve regurgitation within the first year.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Aarhus University Hospital, Skejby, Denmark. hhmn@kirurgi.org
authors.forename: Hans Henrik Møller
authors.initials: HH
authors.lastname: Nielsen
authors.forename: Henrik
authors.initials: H
authors.lastname: Egeblad
authors.forename: Henning Rud
authors.initials: HR
authors.lastname: Andersen
authors.forename: Leif
authors.initials: L
authors.lastname: Thuesen
authors.forename: Steen Hvitfeldt
authors.initials: SH
authors.lastname: Poulsen
authors.forename: Kaj-Erik
authors.initials: KE
authors.lastname: Klaaborg
authors.forename: Carl-Johan
authors.initials: CJ
authors.lastname: Jakobsen
authors.forename: Vibeke Elisabeth
authors.initials: VE
authors.lastname: Hjortdal
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000453:epidemiology*; D001024:Aortic Valve Stenosis / Q000628:therapy*; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000295:instrumentation*; D003718:Denmark / Q000453:epidemiology; D018618:Echocardiography, Doppler, Color; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation*; D006801:Humans; D008297:Male; D015995:Prevalence; D011474:Prosthesis Design; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome