Natural Course of Paravalvular Regurgitation After Implantation of the Self-Expanding CoreValve: Insights From Serial TEE Measurements.

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.