3D Assessment of Features Associated With Transvalvular Aortic Regurgitation After TAVR: A Real-Time 3D TEE Study

JACC. Cardiovascular Imaging
Kentaro ShibayamaTakahiro Shiota

Abstract

This study of 3-dimensional (3D) transesophageal echocardiography (TEE) aimed to demonstrate features associated with transvalvular aortic regurgitation (AR) after transcatheter aortic valve replacement (TAVR) and to confirm the fact that a gap between the native aortic annulus and prosthesis is associated with paravalvular AR. The mechanism of AR after TAVR, particularly that of transvalvular AR, has not been evaluated adequately. All patients with severe aortic stenosis who underwent TAVR with the Sapien device (Edwards Lifesciences, Irvine, California) had 3D TEE of the pre-procedural native aortic annulus and the post-procedural prosthetic valve. In the 201 patients studied, the total AR was mild in 67 patients (33%), moderate in 21 patients (10%), and severe in no patients. There were 20 patients with transvalvular AR and 82 patients with paravalvular AR. Fourteen patients had both transvalvular and paravalvular AR. Patients with transvalvular AR had larger prosthetic expansion (p <0.05), a more elliptical prosthetic shape at the prosthetic commissure level (p <0.01) and more anti-anatomical position (p <0.001), which was defined as malposition of the prosthetic commissures in relation to the native commissures, than the p...Continue Reading

References

Apr 20, 2010·The Journal of Thoracic and Cardiovascular Surgery·Rachid ZegdiJean-Noël Fabiani
Oct 12, 2010·Journal of Cardiothoracic Surgery·Jose Manuel Martinez CereijoJose Manuel Suarez Peñaranda
Jun 7, 2011·The New England Journal of Medicine·Craig R SmithUNKNOWN PARTNER Trial Investigators
Aug 16, 2011·European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology·Jose L ZamoranoThomas Buck
Oct 3, 2012·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Arie Pieter KappeteinUNKNOWN Valve Academic Research Consortium (VARC)-2
Dec 22, 2012·JACC. Cardiovascular Interventions·Kentaro HayashidaMarie-Claude Morice
Dec 26, 2012·Journal of the American College of Cardiology·Stefan ToggweilerJohn G Webb
May 7, 2013·Journal of the American College of Cardiology·Jan-Malte SinningNikos Werner

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Citations

Jul 2, 2020·Echocardiography·Caroline Bleakley, Mark Monaghan
May 5, 2021·Expert Review of Cardiovascular Therapy·Mitsunobu KitamuraMohamed Abdel-Wahab

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