Key result
Management of paravalvular regurgitation after TAVI involves medical therapy for mild cases and surgical or transcatheter interventions for moderate to severe cases.
Provides an overview of management strategies for paravalvular regurgitation following TAVI, ranging from medical therapy to transcatheter and surgical interventions.
Medical management with monitoring suffices for most mild post-TAVI PVR; leaves open optimal thresholds and options for moderate-severe cases.
Management of paravalvular regurgitation (PVR) after transcatheter aortic valve implantation (TAVI). Most patients with mild PVR can be managed medically with periodic imaging to detect any increase in regurgitant severity. In some patients with moderate to severe or severe PVR, medical therapy may be possible using guideline-directed medical therapy for heart failure or haemolytic anaemia. When intervention is needed, surgical aortic valve replacement (SAVR) may be considered, but many of these patients may be high risk for surgery or prefer to avoid surgical intervention. Transcatheter options include a vascular occluder device, a redo TAVI with placement of a second transcatheter valve (TAV-in-TAV), or balloon dilation of the initial TAVI valve.
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Chung et al. (2023) conducted a review in Paravalvular regurgitation after transcatheter aortic valve implantation. Management strategies (medical therapy, SAVR, transcatheter options) was evaluated. Management of paravalvular regurgitation after TAVI involves medical therapy for mild cases and surgical or transcatheter interventions for moderate to severe cases.
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