Quantitative assessment of paravalvular regurgitation following transcatheter aortic valve replacement

• Published in: Journal of cardiovascular magnetic resonance 2015-05, Vol.17 (1), p.32-32, Article 32
• Main Authors: Crouch, Gareth, Tully, Phillip J, Bennetts, Jayme, Sinhal, Ajay, Bradbrook, Craig, Penhall, Amy L, De Pasquale, Carmine G, Baker, Robert A, Selvanayagam, Joseph B
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Aortic Valve - diagnostic imaging; Aortic Valve - physiopathology; Aortic Valve Insufficiency - diagnosis; Aortic Valve Insufficiency - diagnostic imaging; Aortic Valve Insufficiency - etiology; Aortic Valve Insufficiency - physiopathology; Aortic valve stenosis; Aortic Valve Stenosis - diagnosis; Aortic Valve Stenosis - physiopathology; Aortic Valve Stenosis - therapy; Cardiac Catheterization - adverse effects; Care and treatment; Comparative analysis; Electrical equipment and supplies industry; Female; Health aspects; Heart Valve Prosthesis Implantation - adverse effects; Heart Valve Prosthesis Implantation - methods; Hemodynamics; Humans; Magnetic Resonance Imaging; Male; Predictive Value of Tests; Reproducibility of Results; Severity of Illness Index; Stroke Volume; Time Factors; Treatment Outcome; Ultrasonography; Ventricular Function, Left
• ISSN: 1097-6647; 1532-429X
• DOI: 10.1186/s12968-015-0134-0

Paravalvular aortic regurgitation (PAR) following transcatheter aortic valve implantation (TAVI) is well acknowledged. Despite improvements, echocardiographic measurement of PAR largely remains qualitative. Cardiovascular magnetic resonance (CMR) directly quantifies AR with accuracy and reproducibility. We compared CMR and transthoracic echocardiography (TTE) analysis of pre-operative and post-operative aortic regurgitation in patients undergoing both TAVI and surgical aortic valve replacement (AVR). Eighty-seven patients with severe aortic stenosis undergoing TAVI (56 patients) or AVR were recruited. CMR (1.5 T) and transthoracic echocardiography (TTE) were carried out pre-operatively and a median of 6 days post-operatively. The CMR protocol included regurgitant aortic flows using through-plane phase-contrast velocity. None/trivial, mild, moderate and severe AR by CMR was defined as ≤8%, 9-20%, 21-39%, >40% regurgitant fractions respectively. Pre- and post-operative left ventricular ejection fraction (LVEF) was similar. Post-procedure aortic regurgitant fraction using CMR was higher in the TAVI group (TAVI 16 ± 13% vs. AVR 4 ± 4%, p