Key result
Para-valvular regurgitation is more frequent with trans-catheter aortic valve replacement than surgical aortic valve replacement and is associated with worse cardiovascular outcomes.
Why the study?
How is prosthetic valve function and para-valvular regurgitation assessed after trans-catheter aortic valve replacement?
How is prosthetic valve function and para-valvular regurgitation assessed after trans-catheter aortic valve replacement?
Three-dimensional trans-esophageal echocardiography is integral for assessing prosthetic valve function and para-valvular regurgitation after TAVR, which occurs more frequently than with surgical replacement.
Answers are grounded in this paper and cite their sources.
Supports vigilant post-TAVR surveillance for paravalvular regurgitation; leaves open optimal device selection and mitigation in lower-risk patients.
PURPOSE OF REVIEW: To review the current literature on prosthetic valve function and para-valvular regurgitation (PVR) after trans-catheter aortic valve replacement (TAVR). TAVR is a new alternative for the treatment of severe aortic stenosis in patients at high risk for surgical aortic valve replacement and nonsurgical candidates. RECENT FINDINGS: The innovations in three-dimensional trans-esophageal echocardiography have made it an integral part of the TAVR procedure. PVR is more frequent with TAVR than surgical aortic valve replacement and is associated with worse cardiovascular outcomes. Recent publications focus on echocardiographic techniques to better assess the structural components of aortic valve complex, and begin to define the mechanism and risks of PVR after TAVR. SUMMARY: Imaging innovations before, during, and after TAVR may lead to improved patient selection, accelerated development of TAVR prostheses, and ultimately a fuller characterization of the performance and potential limitations of a new generation of prosthetic heart valves.
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Polsani et al. (2013) conducted a review in Severe aortic stenosis. Trans-catheter aortic valve replacement (TAVR) vs. Surgical aortic valve replacement was evaluated. Para-valvular regurgitation is more frequent with trans-catheter aortic valve replacement than surgical aortic valve replacement and is associated with worse cardiovascular outcomes.
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