Paravalvular leak after transcatheter aortic valve implantation: is it anatomically predictable or procedurally determined? MDCT study

Sakrana, Amal Abdelsattar; Nasr, M.M.; Ashamallah, Germeen Albair; Abuelatta, Reda; Naeim, Hesham Abdo; Tahlawi, Mohammad El

doi:10.1016/j.crad.2016.07.016

Cited by 10 publications

(10 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…is variability was assumed to be due to differences in the imaging modalities used in different centers, evaluation timing, the grading system, and variability in prostheses type [15]. In the current study, 29.3% of patients had ≥mild PVL, which is consistent with several reports [8,10,16].…”

Section: Discussionsupporting

confidence: 88%

“…Wong et al [19] reported that elliptical aortic annulus as a predictor of PVL after TAVI. However, several other studies found no correlation, which is consistent with our results [3,8].…”

Section: Risk Factors For Pvlsupporting

confidence: 92%

“…Similarly, a recent study confirmed that aortic regurgitation after TAVI was found to be more frequent in patients with self-expandable prosthesis compared to those with balloon-expandable ones [21]. Conversely, some other studies reported no significant association between prosthesis type and incidence of PVL [8]. In our study, by univariate analysis, prosthesis type had no role in predicting PVL.…”

Section: Prosthesis Typesupporting

confidence: 75%

“…Results from REVIVAL trial showed that larger aortic annulus was a predictor of post-TAVI central aortic regurgitation rather than PVL due to the requirement of larger postdilatation balloon leading to possible leaflet distortion [18]. Conversely, some publications have reported that larger annulus dimensions were not predictors of PVL [7,8]. In the present study, larger annulus dimensions were significantly associated with ≥mild PVL.…”

Section: Risk Factors For Pvlmentioning

confidence: 41%

“…Preprocedural multislice computed tomography (MSCT) is considered the most reliable method for measuring aortic root parameters in patients undergoing TAVI and has shown to be more advantageous in decreasing rates of PVL compared to echocardiography and, hence, has become the preferred imaging method for TAVI patients [4]. Some risk factors for developing PVL after TAVI have been identified [3,[5][6][7][8]. However, there is currently no integrated method which includes all parameters that may predict PVL after TAVI.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Incidence, Predictors, and Outcome of Paravalvular Leak after Transcatheter Aortic Valve Implantation

Hagar

Wei

et al. 2020

Journal of Interventional Cardiology

View full text Add to dashboard Cite

Background. Paravalvular leak (PVL) is common after transcatheter aortic valve implantation (TAVI) and has been linked with worse survival. This study aimed to investigate the determinants and outcome of PVL after TAVI and determine the role of aortic valve calcification (AVC) distribution in predicting PVL. Methods and Results. This was a retrospective cohort study of 270 consecutive patients who underwent TAVI. Determinants and outcomes of ≥mild PVL were assessed. Matching rates of PVL jet with AVC distribution were calculated. AVC volume, larger annulus dimensions, and transvalvular peak velocity were risk factors for ≥mild PVL after TAVI. AVC volume was an independent predictor of ≥mild PVL. On the other hand, annulus ellipticity, left ventricular outflow tract nontubularity, and diameter-derived prosthesis mismatch were not found to predict PVL after TAVI. PVL jet matched, in varying proportions, with calcification at all aortic root regions, and the highest matching rate was with calcifications at body of leaflets. Moreover, matching rates were less with commissure compared to cusp calcifications. Mild or greater PVL was not associated with all-cause and cardiovascular mortality up to 1-year follow-up. Conclusion. ≥mild PVL after TAVI is common and can be predicted by aortic root calcification volume, larger annulus dimensions, and pre-TAVI transvalvular peak velocity, with calcification volume being an independent predictor for PVL. However, annulus ellipticity, left ventricular outflow tract nontubularity, and diameter-derived prosthesis mismatch had no role in predicting PVL. Importantly, body of leaflet calcifications (versus annulus and tip of leaflet) and cusp calcifications (versus commissure calcification) are more important in predicting PVL. No association between ≥mild PVL and increased risk of all-cause and cardiovascular mortality at 1-year follow-up.

show abstract

Section: Discussionsupporting

confidence: 88%

“…Wong et al [19] reported that elliptical aortic annulus as a predictor of PVL after TAVI. However, several other studies found no correlation, which is consistent with our results [3,8].…”

Section: Risk Factors For Pvlsupporting

confidence: 92%