title: Paravalvular regurgitation after transcatheter aortic valve replacement: diagnosis, clinical outcome, preventive and therapeutic strategies.
abstract: Paravalvular regurgitation is a common, potentially life-threatening complication of transcatheter aortic valve replacement. Previous studies report a 65%-94% rate of paravalvular leakage after transcatheter implantation, mostly of mild degree. The rate of significant (≥ +2) paravalvular regurgitation varies in large clinical trials, and is associated with worse clinical outcome. There is less agreement regarding the significance of mild regurgitation (grade 1+). There are anatomical and procedural correlates for paravalvular leak-most importantly, severe valve calcification, patient prosthetic mismatch, and device malposition. The following review details the current knowledge on paravalvular regurgitation after transcatheter aortic valve replacement, including diagnosis, correlates, clinical outcome, preventive and therapeutic strategies related to this complication.
authors.affiliation: Interventional Cardiology, MedStar Washington Hospital Center, 110 Irving Street, NW, Suite 4B-1, Washington, DC 20010, USA.
authors.forename: Danny
authors.initials: D
authors.lastname: Dvir
authors.forename: Israel M
authors.initials: IM
authors.lastname: Barbash
authors.forename: Itsik
authors.initials: I
authors.lastname: Ben-Dor
authors.forename: Rebecca
authors.initials: R
authors.lastname: Torguson
authors.forename: Salem
authors.initials: S
authors.lastname: Badr
authors.forename: Sa'ar
authors.initials: S
authors.lastname: Minha
authors.forename: Lakshmana K
authors.initials: LK
authors.lastname: Pendyala
authors.forename: Joshua P
authors.initials: JP
authors.lastname: Loh
authors.forename: Augusto D
authors.initials: AD
authors.lastname: Pichard
authors.forename: Ron
authors.initials: R
authors.lastname: Waksman
mesh_terms: D001021:Aortic Valve / Q000503:physiopathology*; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control / Q000628:therapy; D001024:Aortic Valve Stenosis / Q000503:physiopathology / Q000628:therapy*; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000295:instrumentation; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D006439:Hemodynamics; D006801:Humans; D011474:Prosthesis Design; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome