TY - JOUR

T1 - Aortic regurgitation after transcatheter aortic valve implantation of the Edwards SAPIEN ™ valve

AU - Nielsen, Hans Henrik Møller

AU - Egeblad, Henrik

AU - Andersen, Henning Rud

AU - Thuesen, Leif

AU - Poulsen, Steen Hvitfeldt

AU - Klaaborg, Kaj-Erik

AU - Jakobsen, Carl-Johan

AU - Hjortdal, Vibeke Elisabeth

PY - 2013/2

Y1 - 2013/2

N2 - INTRODUCTION: Transcatheter aortic valve implantation (TAVI) is established as an attractive treatment option for high-risk patients with aortic valve stenosis. One concern is the high risk of prosthetic valve regurgitation. This study aimed to examine for potential preoperative risk factors for postprocedural transcatheter heart valve regurgitation and to quantify the risk, degree, and consequences of postprocedural regurgitation.MATERIALS AND METHODS: 100 consecutive patients who underwent femoral (n = 22) or transapical (n = 78) TAVI were retrospectively reviewed. Echocardiographic valve regurgitation and clinical parameters were analyzed over the first year after TAVI.RESULTS: Seventy-five percent of all patients had prosthetic valve regurgitation. It was, however, only mild or absent in 64% of patients and did not require re-intervention in any of the patients in the series. The severity of the regurgitation appeared unchanged over the one-year follow-up period. Moderate to severe regurgitation was associated with significant yet stable dilatation of the left ventricle over one year and lesser NYHA class improvement three months after TAVI. Asymmetrical native valve calcification increased the risk of paravalvular regurgitation non-significantly.CONCLUSION: Transcatheter heart valve regurgitation seems to be mild in the majority of cases and unchanged over a 12 months follow-up period. While affecting left ventricular dimensions in moderate or severe cases, we observed no obvious undesirable consequences of the prosthetic valve regurgitation within the first year.

AB - INTRODUCTION: Transcatheter aortic valve implantation (TAVI) is established as an attractive treatment option for high-risk patients with aortic valve stenosis. One concern is the high risk of prosthetic valve regurgitation. This study aimed to examine for potential preoperative risk factors for postprocedural transcatheter heart valve regurgitation and to quantify the risk, degree, and consequences of postprocedural regurgitation.MATERIALS AND METHODS: 100 consecutive patients who underwent femoral (n = 22) or transapical (n = 78) TAVI were retrospectively reviewed. Echocardiographic valve regurgitation and clinical parameters were analyzed over the first year after TAVI.RESULTS: Seventy-five percent of all patients had prosthetic valve regurgitation. It was, however, only mild or absent in 64% of patients and did not require re-intervention in any of the patients in the series. The severity of the regurgitation appeared unchanged over the one-year follow-up period. Moderate to severe regurgitation was associated with significant yet stable dilatation of the left ventricle over one year and lesser NYHA class improvement three months after TAVI. Asymmetrical native valve calcification increased the risk of paravalvular regurgitation non-significantly.CONCLUSION: Transcatheter heart valve regurgitation seems to be mild in the majority of cases and unchanged over a 12 months follow-up period. While affecting left ventricular dimensions in moderate or severe cases, we observed no obvious undesirable consequences of the prosthetic valve regurgitation within the first year.

KW - Aged

KW - Aged, 80 and over

KW - Aortic Valve Insufficiency/diagnostic imaging

KW - Aortic Valve Stenosis/therapy

KW - Cardiac Catheterization/adverse effects

KW - Denmark/epidemiology

KW - Echocardiography, Doppler, Color

KW - Female

KW - Heart Valve Prosthesis

KW - Heart Valve Prosthesis Implantation/adverse effects

KW - Humans

KW - Male

KW - Prevalence

KW - Prosthesis Design

KW - Retrospective Studies

KW - Risk Factors

KW - Severity of Illness Index

KW - Time Factors

KW - Treatment Outcome

U2 - 10.3109/14017431.2012.731519

DO - 10.3109/14017431.2012.731519

M3 - Journal article

C2 - 22989057

VL - 47

SP - 36

EP - 41

JO - Scandinavian Cardiovascular Journal

JF - Scandinavian Cardiovascular Journal

SN - 1401-7458

IS - 1

ER -