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Natural course of paravalvular regurgitation after implantation of the self-expanding corevalve: insights from serial TEE measurements


Toggweiler, Stefan; van Schie, Bram; Zuber, Michel; Sabti, Zaid; Özkartal, Tardu; Lüscher, Thomas F; Erne, Paul (2015). Natural course of paravalvular regurgitation after implantation of the self-expanding corevalve: insights from serial TEE measurements. Journal of Invasive Cardiology, 27(9):435-440.

Abstract

UNLABELLED This study investigates the natural course of paravalvular regurgitation (PAR) with serial transesophageal echocardiography (TEE) measurements. METHODS TEE studies were performed at 30 days and 1 year post TAVI with the self-expanding CoreValve for the treatment of severe aortic valve stenosis in 50 patients. In addition to conventional measurements, PAR perimeter and orifice area were assessed in the cross-sectional short-axis view at the level of the native aortic annulus. RESULTS At 30 days, PAR was classified as none in 26 patients (52%), mild in 19 patients (38%) and moderate in 5 patients (10%). Between 30 days and 1 year, the number and size of PAR jets decreased and PAR was absent in 30 patients (60%) (P=.58 compared with 30-day results). Paravalvular regurgitation perimeter decreased from 8.2 ± 10.9% to 4.7 ± 7.7% (P<.01), a relative reduction of 43%. Cross-sectional area of regurgitation decreased from 0.22 ± 0.36 cm² to 0.12 ± 0.20 cm² (P=.01), a relative reduction of 45%. This improvement was observed in patients with mild and moderate PAR. No patient without PAR at 30 days developed PAR at 1-year follow-up. CONCLUSIONS PAR perimeter and area as visualized by Color-Doppler TEE in the cross-sectional view decreased by about 45% between 30 days and 1 year post implantation of the self-expanding CoreValve.

Abstract

UNLABELLED This study investigates the natural course of paravalvular regurgitation (PAR) with serial transesophageal echocardiography (TEE) measurements. METHODS TEE studies were performed at 30 days and 1 year post TAVI with the self-expanding CoreValve for the treatment of severe aortic valve stenosis in 50 patients. In addition to conventional measurements, PAR perimeter and orifice area were assessed in the cross-sectional short-axis view at the level of the native aortic annulus. RESULTS At 30 days, PAR was classified as none in 26 patients (52%), mild in 19 patients (38%) and moderate in 5 patients (10%). Between 30 days and 1 year, the number and size of PAR jets decreased and PAR was absent in 30 patients (60%) (P=.58 compared with 30-day results). Paravalvular regurgitation perimeter decreased from 8.2 ± 10.9% to 4.7 ± 7.7% (P<.01), a relative reduction of 43%. Cross-sectional area of regurgitation decreased from 0.22 ± 0.36 cm² to 0.12 ± 0.20 cm² (P=.01), a relative reduction of 45%. This improvement was observed in patients with mild and moderate PAR. No patient without PAR at 30 days developed PAR at 1-year follow-up. CONCLUSIONS PAR perimeter and area as visualized by Color-Doppler TEE in the cross-sectional view decreased by about 45% between 30 days and 1 year post implantation of the self-expanding CoreValve.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:September 2015
Deposited On:13 Jan 2016 08:03
Last Modified:05 Apr 2016 19:50
Publisher:H M P Communications, LLC
ISSN:1042-3931
Free access at:Publisher DOI. An embargo period may apply.
PubMed ID:26332879

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