Aortic Regurgitation After Transcatheter Aortic Valve Replacement : Nothing to Worry About Anymore?
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- Werner Nikos
- Heart Center Bonn, Department of Medicine II, University Hospital Bonn
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- Sinning Jan-Malte
- Heart Center Bonn, Department of Medicine II, University Hospital Bonn
書誌事項
- タイトル別名
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- Aortic Regurgitation After Transcatheter Aortic Valve Replacement
- – Nothing to Worry About Anymore? –
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説明
Paravalvular aortic regurgitation (AR) negatively affects prognosis following transcatheter aortic valve replacement (TAVR). As transcatheter heart valves (THV) are anchored using a certain degree of oversizing at the level of the aortic annulus, incomplete stent frame expansion because of heavily annular calcifications, suboptimal placement of the prosthesis, and/or annulus-prosthesis size-mismatch can contribute to paravalvular AR with subsequent increased mortality risk. Echocardiography is essential to differentiate between transvalvular and paravalvular AR and to further elucidate the etiology of AR during the procedure. However, because echocardiographic quantification of AR in TAVR patients remains challenging, especially in the implantation situation, a multimodal approach to the evaluation of AR with use of hemodynamic measurements and imaging modalities is useful to precisely quantify the severity of AR immediately after valve deployment. “Next-generation” THVs are already on the market and first results show that paravalvular AR related to design modifications (eg, paravalvular space-fillers, full repositionability) are rarely seen in these valve types. (Circ J 2014; 78: 811–818)<br>
収録刊行物
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- Circulation Journal
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Circulation Journal 78 (4), 811-818, 2014
一般社団法人 日本循環器学会