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Aortic Regurgitation After Transcatheter Aortic Valve Implantation

  • Bogdan Borz
Chapter

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.

Keywords

Paravalvular aortic regurgitation Mortality Transcatheter aortic valve implantation 

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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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Bogdan Borz
    • 1
    • 2
  1. 1.Clinique de l’UnionSaint-JeanFrance
  2. 2.Rangueil University HospitalToulouseFrance

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