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Paravalvular regurgitation one year after transcatheter aortic valve implantation.
Rajani, Ronak MD, MRCP 1,*; Kakad, Mitesh MBBS 1; Khawaja, Muhammed Z. MRCP, MBBS 1; Lee, Lorraine BSc 1; James, Rachael MD, MRCP 1; Saha, Mrinal MRCP, MBBS 1; Hildick-Smith, David MD, FRCP 1
[Article] Catheterization & Cardiovascular Interventions. 75(6):868-872, May 1, 2010.

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Objectives: The aim of this study was to assess the natural history of paravalvular regurgitation at 1 year in patients undergoing TAVI.

Background: The immediate incidence of paravalvular regurgitation is estimated to be between 65 and 85% following transcatheter aortic valve implantation (TAVI). There is limited data as to whether this deteriorates during follow-up.

Methods: Forty-six patients were recruited from a TAVI programme at our institute. All patients underwent an assessment of prosthetic valve function periprocedurally with aortography and immediately postprocedurally with transthoracic echocardiography. Twenty-one patients with a median age was 83 (66-91) years of whom 14 were male reached 1 year follow-up, 13 of whom were available for repeat transthoracic echocardiography.

Results: The incidence of paravalvular regurgitation immediately following TAVI was 86%. Of them 57% had <= mild regurgitation and 29% had > mild regurgitation. At 1 year the incidence of paravalvular regurgitation was 77%. 54% had <= mild regurgitation and 34% > mild regurgitation. No patient had severe regurgitation. The degree of regurgitation reduced in 6 (46%), stayed the same in 3 (23%), and increased in 4 (31%) of patients.

Conclusions: Patients undergoing TAVI have an immediate postprocedural risk of regurgitation of 86%. In the majority of cases the degree of paravalvular CoreValve(R) regurgitation is mild, and remains stable in 70% of patients during medium term follow-up. (C) 2009 Wiley-Liss, Inc.