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Aortic Regurgitation After Transcatheter Aortic Valve Implantation

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Transcatheter Aortic Valve Implantation

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Abstract

Paravalvular aortic regurgitation (PAR) is a major complication of transcatheter aortic valve implantation (TAVI). While the incidence of moderate to severe PAR reported with the early generation of aortic transcatheter valves varied between 12% and 21%, the last generation of valves decreased the incidence of moderate to severe PAR to 1–5%. Assessment of PAR is difficult due to the presence of multiple jets and irregular orifices of regurgitation. Recent grading classifications have improved the quality and coherence of reports evaluating residual PAR after TAVI. Since moderate or severe PAR has been consistently associated with increased mortality, systematic evaluation of PAR is mandatory. Various solutions for reducing residual PAR exist: post-dilation, implantation of a second valve, or percutaneous closure.

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Abbreviations

AR:

Aortic regurgitation

BE:

Balloon-expandable

CMR:

Cardiovascular magnetic resonance imaging

DBP:

Diastolic blood pressure

LV:

Left ventricle

LVEDP:

Left ventricular end-diastolic pressure

LVOT:

Left ventricular outflow tract

MRI:

Magnetic resonance imaging

PAR:

Paravalvular aortic regurgitation

SAVR:

Surgical valve replacement

SE:

Self-expandable

TAVI:

Transcatheter aortic valve implantation

TEE:

Transesophageal echocardiography

THV:

Transcatheter heart valve

TTE:

Transthoracic echocardiography

VARC:

Valve Academic Research Consortium

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Authors and Affiliations

  1. Clinique de l’Union, Saint-Jean, France

    Bogdan Borz

  2. Rangueil University Hospital, Toulouse, France

    Bogdan Borz

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  1. Interventional Cardiology Unit, Pineta Grande Hospital, Castel Volturno, Caserta, Italy

    Arturo Giordano

  2. Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy

    Giuseppe Biondi-Zoccai  & Giacomo Frati  & 

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Borz, B. (2019). Aortic Regurgitation After Transcatheter Aortic Valve Implantation. In: Giordano, A., Biondi-Zoccai, G., Frati, G. (eds) Transcatheter Aortic Valve Implantation. Springer, Cham. https://doi.org/10.1007/978-3-030-05912-5_14

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  • DOI: https://doi.org/10.1007/978-3-030-05912-5_14

  • Publisher Name: Springer, Cham

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