Valvular leak after transcatheter aortic valve implantation: a clinician update on epidemiology, pathophysiology and clinical implications.
Year: 2011
Type: article
Abstract: During trascatheter aortic valve implantation (TAVI) the native valve is not removed but crushed. Thus, a slight prosthesis insufficiency is not uncommon and has been reported in about 70% of patients for both available types of percutaneous valves. However, the definition of clinically "significant" valve regurgitation is not fully established yet. In most cases, aortic insufficiency is mild and clinical acceptable, however, severe insufficiency can occur. Paravalvular insufficiency is usually prevalent, and it may be the consequence of prosthesis/patient mismatch due to an undersizing of the implanted device or to an incomplete expansion of the prosthesis stent frame, or also to incorrect site of prosthesis implantation. Thus, an accurate assessment of the aortic valve annulus before TAVI is mandatory in order to select the optimal size of the valve. The presence of large calcium burden or bicuspid valve as well as the correct implantation of the device are other key determinants of final valve insufficiency. When severe regurgitation is present, an integration of hemodynamic, angiographic, transthoracic and TEE data is necessary to tailor the best clinical decision on a per-patient basis.
Source: Europe PMC (PubMed Central)
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W1556041881