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Assessment of Paravalvular Regurgitation Following Transcatheter Aortic Valve Replacement

Rebecca T Hahn1

  • 1Center for Interventional Vascular Therapy, Columbia University Medical Center, New York-Presbyterian Hospital, 161 Fort Washington Avenue, New York, NY 10032, USA.

Interventional Cardiology Clinics
|June 6, 2017
PubMed

Insights

Paravalvular regurgitation after transcatheter aortic valve replacement is a complication impacting patient outcomes. This review covers methods to assess paravalvular regurgitation severity, detailing their strengths and weaknesses.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Interventional Cardiology

Background:

  • Paravalvular regurgitation (PVR) is a recognized complication following transcatheter aortic valve replacement (TAVR).
  • PVR is associated with adverse clinical outcomes and increased mortality.
  • Accurate assessment of PVR severity is crucial for patient management.

Purpose of the Study:

  • To review and compare current techniques for assessing PVR severity after TAVR.
  • To discuss the advantages and limitations of each assessment modality.
  • To provide guidance on selecting appropriate methods for PVR evaluation.

Main Methods:

  • Review of existing literature on PVR assessment modalities.
  • Inclusion of techniques such as angiography, hemodynamic assessment, cardiac MRI, and echocardiography.
  • Analysis of the strengths and pitfalls of each diagnostic tool.

Main Results:

  • Each modality (angiography, hemodynamics, MRI, echocardiography) offers unique insights into PVR severity.
  • Echocardiography is frequently used but has limitations.
  • Angiography and hemodynamics provide functional data, while MRI offers detailed anatomical visualization.

Conclusions:

  • No single modality is perfect for assessing PVR severity.
  • A multi-modality approach may be necessary for comprehensive evaluation.
  • Understanding the strengths and weaknesses of each technique optimizes PVR assessment and patient care.
Keywords:
Cardiac MRICineangiographyEchocardiographyInvasive hemodynamicsParavalvular regurgitationTranscatheter aortic valve replacement

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