Skip to main content
SpringerLink
Log in

The Role of Imaging in Paravalvular Leak Assessment

  • Chapter
  • First Online:
Transcatheter Paravalvular Leak Closure

Abstract

Paravalvular leaks (PVLs), defined as abnormal retrograde communication between the cardiac chambers adjacent to a prosthetic valve, are a relatively uncommon complication associated with valve replacement. Although real prevalence is unknown and differs widely among different studies, the presence of a certain degree of paravalvular regurgitation is not infrequent after prosthetic valve implantation, with an overall reported incidence of 47%. However, the prevalence of significant PVL with potential clinical consequences is estimated between 1 and 12%. Some studies have demonstrated a higher incidence of PVL after surgical mitral valve replacement (2–12%) than following surgical aortic valve replacement (1–5%). Furthermore, the exponential growth of technology in the field of percutaneous valve replacement, especially the well-established use of transcatheter aortic valve replacement (TAVR), has been associated with an increased risk of PVL with an incidence up to 17%. In contrast, PVLs are rarely detected in the pulmonary or tricuspid position [1–8].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 54.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Kliger C, Eiros R, Isasti G, Einhorn B, Jelnin V, Cohen H, et al. Review of surgical prosthetic paravalvular leaks: diagnosis and catheter-based closure. Eur Heart J. 2013;34(9):638–49.

    Article  PubMed  Google Scholar 

  2. Ionescu A, Fraser AG, Butchart EG. Prevalence and clinical significance of incidental paraprosthetic valvar regurgitation: a prospective study using transoesophageal echocardiography. Heart. 2003;89(11):1316–21.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Chen YT, Kan MN, Chen JS, Lin WW, Chang MK, WS H, et al. Detection of prosthetic mitral valve leak: a comparative study using transesophageal echocardiography, transthoracic echocardiography, and auscultation. J Clin Ultrasound. 1990;18(7):557–61.

    Article  CAS  PubMed  Google Scholar 

  4. Bernal JM, Rabasa JM, Cagigas JC, Echevarria JR, Carrion MF, Revuelta JM. Valve-related complications with the Hancock I porcine bioprosthesis. A twelve- to fourteen-year follow-up study. J Thorac Cardiovasc Surg. 1991;101(5):871–80.

    CAS  PubMed  Google Scholar 

  5. Miller DL, Morris JJ, Schaff HV, Mullany CJ, Nishimura RA, Orszulak TA. Reoperation for aortic valve periprosthetic leakage: identification of patients at risk and results of operation. J Heart Valve Dis. 1995;4(2):160–5.

    CAS  PubMed  Google Scholar 

  6. Jindani A, Neville EM, Venn G, Williams BT. Paraprosthetic leak: a complication of cardiac valve replacement. J Cardiovasc Surg. 1991;32(4):503–8.

    CAS  Google Scholar 

  7. Wasowicz M, Meineri M, Djalani G, et al. Early complications and immediate postoperative outcomes of paravalvular leaks after valve replacement surgery. J Cardiothorac Vasc Anesth. 2011;25(4):610–4.

    Article  PubMed  Google Scholar 

  8. Rallidis LS, Moyssakis IE, Ikonomidis I, Nihoyannopoulos P. Natural history of early aortic paraprosthetic regurgitation: a five-year follow-up. Am Heart J. 1999;138:351–7.

    Article  CAS  PubMed  Google Scholar 

  9. De Cicco G, Lorusso R, Colli A, Nicolini F, Fragnito C, Grimaldi T, et al. Aortic valve periprosthetic leakage: anatomic observations and surgical results. Ann Thorac Surg. 2005;79:1480–5.

    Article  PubMed  Google Scholar 

  10. De Cicco G, Russo C, Moreo A, Beghi C, Fucci C, Gerometta P, et al. Mitral valve periprosthetic leakage: anatomical observations in 135 patients from a multicentre study. Eur J Cardiothorac Surg. 2006;30:887–91.

    Article  PubMed  Google Scholar 

  11. Safi AM, Kwan T, Afflu E, et al. Paravalvular regurgitation: a rare complication following valve replacement surgery. Angiology. 2000;51:479–87.

    Article  CAS  PubMed  Google Scholar 

  12. Pate GE, Al Zubaidi A, Chandavimol M, Thompson CR, Munt BI, Webb JG. Percutaneous closure of prosthetic paravalvular leaks: case series and review. Catheter Cardiovasc Interv. 2006;68:528–33.

    Article  PubMed  Google Scholar 

  13. Davila-Roman VG, Waggoner AD, Kennard ED, Holubkov R, Jamieson WR, Englberger L, et al. Prevalence and severity of paravalvular regurgitation in the artificial valve endocarditis reduction trial (avert) echocardiography study. J Am Coll Cardiol. 2004;44:1467–72.

    Article  PubMed  Google Scholar 

  14. García E, Sandoval J, Unzue L, et al. Paravalvular leaks: mechanisms, diagnosis and management. EuroIntervention. 2012;8(Suppl Q):Q41–52.

    Article  PubMed  Google Scholar 

  15. Ruiz CE, Jelnin V, Kronzon I, Dudiy Y, Del Valle-Fernandez R, Einhorn BN, et al. Clinical outcomes in patients undergoing percutaneous closure of periprosthetic paravalvular leaks. J Am Coll Cardiol. 2011;58:2210–7.

    Article  PubMed  Google Scholar 

  16. Sorajja P, Cabalka AK, Hagler DJ, Rihal CS. Percutaneous repair of paravalvular prosthetic regurgitation: acute and 30-day outcomes in 115 patients. Circ Cardiovasc Interv. 2011;4:314–21.

    Article  PubMed  Google Scholar 

  17. Skoularigis J, Essop MR, Skudicky D, Middlemost SJ, Sareli P. Frequency and severity of intravascular hemolysis after left-sided cardiac valve replacement with medtronic hall and St. Jude medical prostheses, and influence of prosthetic type, position, size and number. Am J Cardiol. 1993;71:587–91.

    Article  CAS  PubMed  Google Scholar 

  18. Hourihan M, Perry SB, Mandell VS, Keane JF, Rome JJ, Bittl JA, et al. Transcatheter umbrella closure of valvular and paravalvular leaks. J Am Coll Cardiol. 1992;20:1371–7.

    Article  CAS  PubMed  Google Scholar 

  19. Dumesnil J, Pibarot P. Doppler echocardiographic evaluation of prosthetic valve function. Heart. 2012;98:69–78.

    Article  PubMed  Google Scholar 

  20. Zoghbi WA, Enriquez-Sarano M, Foster E, et al. Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. J Am Soc Echocardiogr. 2003;16:777–802.

    Article  PubMed  Google Scholar 

  21. Effron MK, Popp RL. Two-dimensional echocardiographic assessment of bioprosthetic valve dysfunction and infective endocarditis. J Am Coll Cardiol. 1983;2:597–606.

    Article  CAS  PubMed  Google Scholar 

  22. Daniel LB, Grigg LE, Weisel RD, Rakowski H. Comparison of transthoracic and transesophageal assessment of prosthetic valve dysfunction. Echocardiography. 1990;7:83–95.

    Article  CAS  PubMed  Google Scholar 

  23. Alton M, Pasierski TJ, Orsinelli DA, Eaton GM, Pearson AC. Comparison of transthoracic and transesophageal echocardiography in evaluation of 47 Starr-Edwards prosthetic valves. J Am Coll Cardiol. 1992;20:1503–11.

    Article  CAS  PubMed  Google Scholar 

  24. Van den Brink RB. Evaluation of prosthetic heart valves by transesophageal echocardiography: problems, pitfalls, and timing of echocardiography. Semin Cardiothorac Vasc Anesth. 2006;10(1):89–100.

    Article  PubMed  Google Scholar 

  25. Rahko PS. Assessing prosthetic mitral valve regurgitation by transoesophageal echo/Doppler. Heart. 2004;90(5):476–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Bach DS. Transesophageal echocardiographic (TEE) evaluation of prosthetic valves. Cardiol Clin. 2000;18:751–71.

    Article  CAS  PubMed  Google Scholar 

  27. Vitarelli A, Conde Y, Cimino E, et al. Assessment of severity of mechanical prosthetic mitral regurgitation by transoesophageal echocardiography. Heart. 2004;90:539–44.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Flachskampf FA, Hoffmann R, Franke A, et al. Does multiplane transesophageal echocardiography improve the assessment of prosthetic valve regurgitation? J Am Soc Echocardiogr. 1995;8:70–8.

    Article  CAS  PubMed  Google Scholar 

  29. Tsang W, Weinert L, Kronzon I, Lang RM. Three-dimensional echocardiography in the assessment of prosthetic valves. Rev Esp Cardiol. 2011;64:1–7.

    Article  PubMed  Google Scholar 

  30. Kort S. Real-time 3-dimensional echocardiography for prosthetic valve endocarditis: initial experience. J Am Soc Echocardiogr. 2006;19:130–9.

    Article  PubMed  Google Scholar 

  31. Sugeng L, Shernan SK, Weinert L, et al. Real-time three-dimensional transesophageal echocardiography in valve disease: comparison with surgical findings and evaluation of prosthetic valves. J Am Soc Echocardiogr. 2008;21:1347–54.

    Article  PubMed  Google Scholar 

  32. Singh P, Manda J, Hsiung MC, et al. Live/real time three-dimensional transesophageal echocardiographic evaluation of mitral and aortic valve prosthetic paravalvular regurgitation. Echocardiography. 2009;26:980–7.

    Article  PubMed  Google Scholar 

  33. Kronzon I, Sugeng L, Perk G, et al. Real-time 3-dimensional transesophageal echocardiography in the evaluation of post-operative mitral annuloplasty ring and prosthetic valve dehiscence. J Am Coll Cardiol. 2009;53:1543–7.

    Article  PubMed  Google Scholar 

  34. Marcos-Alberca P, Zamorano JL, Sanchez T, et al. Intraoperative monitoring with transesophageal real-time three-dimensional echocardiography during transapical prosthetic aortic valve implantation. Rev Esp Cardiol. 2010;63:352–6.

    Article  PubMed  Google Scholar 

  35. Dobarro D, Gomez-Rubin MC, Lopez-Fernandez T, et al. Real time three-dimensional transesophageal echocardiography for guiding percutaneous mitral valvuloplasty. Echocardiography. 2009;26:746–8.

    Article  PubMed  Google Scholar 

  36. Perk G, Lang RM, Garcia-Fernandez MA, et al. Use of real time three-dimensional transesophageal echocardiography in intracardiac catheter based interventions. J Am Soc Echocardiogr. 2009;22:865–82.

    Article  PubMed  Google Scholar 

  37. Becerra JM, Almeria C, de Isla LP, Zamorano J. Usefulness of 3D transoesophageal echocardiography for guiding wires and closure devices in mitral perivalvular leaks. Eur J Echocardiogr. 2009;10(8):979–81.

    PubMed  Google Scholar 

  38. Osman F, Steeds R. Use of intra-cardiac ultrasound in the diagnosis of prosthetic valve malfunction. Eur J Echocardiogr. 2007;8:392–4.

    Article  PubMed  Google Scholar 

  39. Asrress KN, Mitchell AR. Intracardiac echocardiography. Heart. 2009;95:327–31.

    Article  CAS  PubMed  Google Scholar 

  40. Deftereos S, Giannopoulos G, Raisakis K, Kaoukis A, Kossyvakis C. Intracardiac echocardiography imaging of periprosthetic valvular regurgitation. Eur J Echocardiogr. 2010;11(5):E20.

    PubMed  Google Scholar 

  41. Bartel T, Konorza T, Neudorf U, Ebralize T, Eggebrecht H, Gutersohn A, et al. Intra4cardiac echocardiography: an ideal guiding tool for device closure of interatrial communications. Eur J Echocardiogr. 2005;6:92–6.

    Article  PubMed  Google Scholar 

  42. Picano E, Pibarot P, Lancellotti P, et al. The emerging role of exercise testing and stress echocardiography in valvular heart disease. J Am Coll Cardiol. 2009;54:2251–60.

    Article  PubMed  Google Scholar 

  43. Lancellotti P, Pibarot P, Chambers J, Edvardsen T, Delgado V, Dulgheru R, et al. Recommendations for the imaging assessment of prosthetic heart valves: a report from the European Association of Cardiovascular Imaging endorsed by the Chinese Society of Echocardiography, the Inter-American Society of Echocardiography, and the Brazilian Department of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2016;17(6):589–90.

    Article  PubMed  Google Scholar 

  44. Zoghbi WA, Chambers JB, Dumesnil JG, Foster E, Gottdiener JS, Grayburn PA, et al. Recommendations for evaluation of prosthetic valves with echocardiography and Doppler ultrasound: a report From the American Society of Echocardiography’s Guidelines and Standards Committee and the Task Force on Prosthetic Valves, developed in conjunction with the American College of Cardiology Cardiovascular Imaging Committee, Cardiac Imaging Committee of the American Heart Association, the European Association of Echocardiography, a registered branch of the European Society of Cardiology, the Japanese Society of Echocardiography and the Canadian Society of Echocardiography, endorsed by the American College of Cardiology Foundation, American Heart Association, European Association of Echocardiography, a registered branch of the European Society of Cardiology, the Japanese Society of Echocardiography, and Canadian Society of Echocardiography. J Am Soc Echocardiogr. 2009;22(9):975–1014. quiz 82–4

    Article  PubMed  Google Scholar 

  45. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP III, Guyton RA, et al. AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63(22):e57–185.

    Article  PubMed  Google Scholar 

  46. Magne J, Lancellotti P, Pierard LA. Exercise pulmonary hypertension in asymptomatic degenerative mitral regurgitation. Circulation. 2010;122:33–41.

    Article  PubMed  Google Scholar 

  47. Jaffe WM, Coverdale HA, Roche AHG, et al. Rest and exercise hemodynamics of 20 to 23 mm allograft, Medtronic Intact (porcine), and St. Jude medical valves in the aortic position. J Thorac Cardiovasc Surg. 1990;100:167–74.

    CAS  PubMed  Google Scholar 

  48. Lancellotti P, Magne J. Stress echocardiography in regurgitant valve disease. Circ Cardiovasc Imaging. 2013;6(5):840–9.

    Article  PubMed  Google Scholar 

  49. Pibarot P, Dumesnil JG, Jobin J, et al. Usefulness of the indexed effective orifice area at rest in predicting an increase in gradient during maximum exercise in patients with a bioprosthesis in the aortic valve position. Am J Cardiol. 1999;83:542–6.

    Article  CAS  PubMed  Google Scholar 

  50. Chambers J, Rimington H, Rajani R, et al. Hemodynamic performance on exercise: comparison of a stentless and stented biological aortic valve replacement. J Heart Valve Dis. 2004;13:729–33.

    PubMed  Google Scholar 

  51. Newland JA, Tamuno P, Pasupati S, et al. Emerging role of MDCT in planning complex structural transcatheter intervention. J Am Coll Cardiol Imag. 2014;7:627–31.

    Article  Google Scholar 

  52. Raff GL, Abidov A, Achenbach S, et al. Society of Cardiovascular Computed Tomography. SCCT guidelines for the interpretation and reporting of coronary computed tomographic angiography. J Cardiovasc Comput Tomogr. 2009;3:122–36.

    Article  PubMed  Google Scholar 

  53. Blanke P, Schoepf UJ, Leipsic JA. Computed tomography in transcatheter aortic valve replacement. Radiology. 2013;269:650–69.

    Article  PubMed  Google Scholar 

  54. Leipsic J, LaBounty TM, Ajlan AM, et al. A prospective randomized trial comparing image quality, study interpretability, and radiation dose of narrow acquisition window with widened acquisition window protocols in prospectively ECG-triggered coronary computed tomography angiography. J Cardiovasc Comput Tomogr. 2013;7:18–24.

    Article  PubMed  Google Scholar 

  55. Jelnin V, Co J, Muneer B, Swaminathan B, Toska S, Ruiz CE. Three dimensional CT angiography for patients with congenital heart disease: Scanning protocol for pediatric patients. Catheter Cardiovasc Interv. 2006;67:120–6.

    Article  PubMed  Google Scholar 

  56. Quail MA, Nordmeyer J, Schievano S, Reinthaler M, Mullen MJ, Taylor AM. Use of cardiovascular magnetic resonance imaging for TAVR assessment in patients with bioprosthetic aortic valves: comparison with computed tomography. Eur J Radiol. 2012;81:3912–7.

    Article  PubMed  Google Scholar 

  57. Numata S, Tsutsumi Y, Monta O, Yamazaki S, Seo H, Yoshida S, et al. Mechanical valve evaluation with four-dimensional computed tomography. J Heart Valve Dis. 2013;22:837–42.

    PubMed  Google Scholar 

  58. O’Neill AC, Martos R, Murtagh G, Ryan ER, McCreery C, Keane D, et al. Practical tips and tricks for assessing prosthetic valves and detecting paravalvular regurgitation using cardiac CT. J Cardiovasc Comput Tomogr. 2014;8(4):323–7.

    Article  PubMed  Google Scholar 

  59. Soulen RL, Budinger TF, Higgins CB. Magnetic resonance imaging of prosthetic heart valves. Radiology. 1985;154:705–7.

    Article  CAS  PubMed  Google Scholar 

  60. Walker PG, Pedersen EM, Oyre S, Flepp L, Ringgaard S, Heinrich RS, et al. Magnetic resonance velocity imaging: A new method for prosthetic heart valve study. J Heart Valve Dis. 1995;4:296–307.

    CAS  PubMed  Google Scholar 

  61. Salaun E, Jacquier A, Theron A, Giorgi R, Lambert M, Jaussaud N, et al. Value of CMR in quantification of paravalvular aortic regurgitation after TAVI. Eur Heart J Cardiovasc Imaging. 2016;17(1):41–50.

    CAS  PubMed  Google Scholar 

  62. Lerakis S, Hayek S, Arepalli CD, Thourani V, Babaliaros V. Cardiac magnetic resonance for paravalvular leaks in post-transcatheter aortic valve replacement. Circulation. 2014;129:e430–1.

    Article  PubMed  Google Scholar 

  63. Ribeiro HB, Le Ven F, Larose E, Dahou A, Nombela-Franco L, Urena M, et al. Cardiac magnetic resonance versus transthoracic echocardiography for the assessment and quantification of aortic regurgitation in patients undergoing transcatheter aortic valve implantation. Heart. 2014;100:1924–32.

    Article  PubMed  Google Scholar 

  64. Hartlage GR, Babaliaros VC, Thourani VH, Hayek S, Chrysohoou C, Ghasemzadeh N, et al. The role of cardiovascular magnetic resonance in stratifying paravalvular leak severity after transcatheter aortic valve replacement: an observational outcome study. J Cardiovasc Magn Reson. 2014;16:93.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Hundley WG, Bluemke DA, Finn JP, Flamm SD, Fogel MA, Friedrich MG, et al. ACCF/ACR/AHA/NASCI/SCMR 2010 expert consensus document on cardiovascular magnetic resonance: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents. Circulation. 2010;121:2462–508.

    Article  PubMed  Google Scholar 

  66. Myerson SG, D’Arcy J, Mohiaddin R, Greenwood JP, Karamitsos TD, Francis JM, et al. Aortic regurgitation quantification using cardiovascular magnetic resonance: association with clinical outcome. Circulation. 2012;126:1452–60.

    Article  PubMed  Google Scholar 

  67. Gelfand EV, Hughes S, Hauser TH, Yeon SB, Goepfert L, Kissinger KV, et al. Severity of mitral and aortic regurgitation as assessed by cardiovascular magnetic resonance: optimizing correlation with Doppler echocardiography. J Cardiovasc Magn Reson. 2006;8:503–7.

    Article  PubMed  Google Scholar 

  68. Cawley PJ, Hamilton-Craig C, Owens DS, Krieger EV, Strugnell WE, Mitsumori L, et al. Prospective comparison of valve regurgitation quantitation by cardiac magnetic resonance imaging and transthoracic echocardiography. Circ Cardiovasc Imaging. 2013;6:48–57.66.

    Article  PubMed  Google Scholar 

  69. Franco E, Almeria C, de Agustin JA, Arreo Del Val V, Gomez de Diego JJ, Garcia Fernandez MA, et al. Three-dimensional color Doppler transesophageal echocardiography for mitral paravalvular leak quantification and evaluation of percutaneous closure success. J Am Soc Echocardiogr. 2014;27(11):1153–63.

    Article  PubMed  Google Scholar 

  70. Arribas-Jimenez A, Rama-Merchan JC, Barreiro-Perez M, Merchan-Gomez S, Iscar-Galan A, Martin-Garcia A, et al. Utility of real-time 3-dimensional transesophageal echocardiography in the assessment of mitral paravalvular leak. Circ J. 2016;80(3):738–44.

    Article  PubMed  Google Scholar 

  71. Leon MB, Smith CR, Mack M, et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med. 2010;363(17):1597–607.

    Article  CAS  PubMed  Google Scholar 

  72. Smith CR, Leon MB, Mack MJ, et al. Transcatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med. 2011;364(23):2187–98.

    Article  CAS  PubMed  Google Scholar 

  73. Hahn RT, Pibarot P, Stewart WJ, et al. Comparison of transcatheter and surgical aortic valve replacement in severe aortic stenosis: a longitudinal study of echocardiography parameters in cohort A of the PARTNER trial (Placement of Aortic Transcatheter Valves). J Am Coll Cardiol. 2013;61(25):2514–21.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Kodali SK, Williams MR, Smith CR, Svensson LG, Webb JG, Makkar RR, et al. PARTNER Trial Investigators. Two-year outcomes after transcatheter or surgical aortic-valve replacement. N Engl J Med. 2012;366:1686–95.

    Google Scholar 

  75. Rodés-Cabau J, Webb JG, Cheung A, Ye J, Dumont E, Osten M, et al. Long-term outcomes after transcatheter aortic valve implantation. Insights on prognostic factors and valve durability from the Canadian multicenter experience. J Am Coll Cardiol. 2012;60:1864–75.

    Article  PubMed  Google Scholar 

  76. Makkar RR, Fontana GP, Jilaihawi H, Kapadia S, Pichard AD, Douglas PS, et al. Transcatheter aortic-valve replacement for inoperable severe aortic stenosis. N Engl J Med. 2012;366:1696–704.

    Article  CAS  PubMed  Google Scholar 

  77. Athappan G, Patvardhan E, Tuzcu EM, Svensson LG, Lemos PA, Fraccaro C, et al. Incidence, predictors, and outcomes of aortic regurgitation after transcatheter aortic valve replacement: meta-analysis and systematic review of literature. J Am Coll Cardiol. 2013;61:1585–95.

    Article  PubMed  Google Scholar 

  78. Zamorano JL, Badano LP, Bruce C, Chan KL, Gonçalves A, Hahn RT, et al. EAE/ASE recommendations for the use of echocardiography in new transcatheter interventions for valvular heart disease. J Am Soc Echocardiogr. 2011;24:937–65.

    Article  PubMed  Google Scholar 

  79. Genereux P, Head SJ, Hahn R, Daneault B, Kodali S, Williams MR, et al. Paravalvular leak after transcatheter aortic valve replacement: the new Achilles’ heel? A comprehensive review of the literature. J Am Coll Cardiol. 2013;61:1125–36.

    Article  PubMed  Google Scholar 

  80. Sinning JM, Vasa-Nicotera M, Chin D, Hammerstingl C, Ghanem A, Bence J, et al. Evaluation and management of paravalvular aortic regurgitation after transcatheter aortic valve replacement. J Am Coll Cardiol. 2013;62:11–20.

    Article  PubMed  Google Scholar 

  81. Gonçalves A, Almeria C, Marcos-Alberca P, Feltes G, Hernández-Antolín R, Rodriguez E, et al. Three-dimensional echocardiography in paravalvular aortic regurgitation assessment after transcatheter aortic valve implantation. J Am Soc Echocardiogr. 2012;25:47–55.

    Article  PubMed  Google Scholar 

  82. Kappetein AP, Head SJ, Genereux P, Piazza N, van Mieghem NM, Blackstone EH, et al. Updated standardized endpoint definitions for transcatheter aortic valve implantation: the Valve Academic Research Consortium-2 consensus document. J Am Coll Cardiol. 2012;60:1438–54.

    Article  PubMed  Google Scholar 

  83. Lesser JR, Han BK, Newell M, Schwartz RS, Pedersen W, Sorajja P. Use of cardiac CT angiography to assist in the diagnosis and treatment of aortic prosthetic paravalvular leak: a practical guide. J Cardiovasc Comput Tomogr. 2015;9(3):159–64.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Cardiology Department, University Hospital Ramón y Cajal, Madrid, Spain

    David del Val Martín & Jose Luis Zamorano Gómez

Authors
  1. David del Val Martín
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jose Luis Zamorano Gómez
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jose Luis Zamorano Gómez .

Editor information

Editors and Affiliations

  1. Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland

    Grzegorz Smolka

  2. Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland

    Wojciech Wojakowski

  3. Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland

    Michal Tendera

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer Nature Singapore Pte Ltd.

About this chapter

Cite this chapter

del Val Martín, D., Gómez, J.L.Z. (2017). The Role of Imaging in Paravalvular Leak Assessment. In: Smolka, G., Wojakowski, W., Tendera, M. (eds) Transcatheter Paravalvular Leak Closure. Springer, Singapore. https://doi.org/10.1007/978-981-10-5400-6_2

Download citation

  • DOI: https://doi.org/10.1007/978-981-10-5400-6_2

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-10-5399-3

  • Online ISBN: 978-981-10-5400-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation