Why the study?
Higher-than-expected echocardiographic gradients after transcatheter aortic valve replacement are not uncommon and can be related to different clinical settings, warranting a practical interpretive approach.
How can high residual echocardiographic gradients after TAVR be interpreted using a multiparametric approach?
How can high residual echocardiographic gradients after TAVR be interpreted using a multiparametric approach?
This case series provides a practical framework for interpreting high post-TAVR gradients using both echocardiography and invasive hemodynamics.
May guide differentiation of high post-TAVR gradients in select cases; hypothesis-generating and requires prospective validation.
Echocardiography is a well-established tool for evaluating bioprosthetic valve performance after transcatheter aortic valve replacement. The presence of higher-than-expected echocardiographic gradients is not an uncommon finding and can be related to different clinical settings. This case series proposes a practical and multiparametric approach to interpreting high residual gradients after transcatheter aortic valve replacement. We examine 4 common clinical scenarios: 1) pressure recovery; 2) high-flow state; 3) prosthesis-patient mismatch; and 4) suboptimal valve expansion. For each scenario, a comprehensive echocardiographic analysis, along with invasive hemodynamic evaluation, is reported.
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Arturi et al. (2025) studied this question.
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