Paravalvular regurgitation one year after transcatheter aortic valve implantation

Objectives : The aim of this study was to assess the natural history of paravalvular regurgitation at 1 year in patients undergoing TAVI. Background : The immediate incidence of paravalvular regurgitation is estimated to be between 65 and 85% following transcatheter aortic valve implantation (TAVI). There is limited data as to whether this deteriorates during follow‐up. Methods : Forty‐six patients were recruited from a TAVI programme at our institute. All patients underwent an assessment of prosthetic valve function periprocedurally with aortography and immediately postprocedurally with transthoracic echocardiography. Twenty‐one patients with a median age was 83 (66–91) years of whom 14 were male reached 1 year follow‐up, 13 of whom were available for repeat transthoracic echocardiography. Results : The incidence of paravalvular regurgitation immediately following TAVI was 86%. Of them 57% had ≤ mild regurgitation and 29% had > mild regurgitation. At 1 year the incidence of paravalvular regurgitation was 77%. 54% had ≤ mild regurgitation and 34% > mild regurgitation. No patient had severe regurgitation. The degree of regurgitation reduced in 6 (46%), stayed the same in 3 (23%), and increased in 4 (31%) of patients. Conclusions : Patients undergoing TAVI have an immediate postprocedural risk of regurgitation of 86%. In the majority of cases the degree of paravalvular CoreValve® regurgitation is mild, and remains stable in 70% of patients during medium term follow‐up. © 2009 Wiley‐Liss, Inc.