Abstract 12360: Aortic Regurgitation Following Transcatheter Aortic Valve Implantation: Its Implications And Evolution
Background: To examine the changes over time of aortic regurgitation (AR) following transcatheter aortic valve implantation (TAVI) and its impact on cardiac performance.
Methods and Results: A total of 175 patients (age 81+7 years, 37% men) with >12 months follow-up post-TAVI were included. Detailed echocardiography was performed at baseline, before discharge, 6 months and >12 months post-TAVI. AR was assessed in terms of overall, paravalvular and intravalvular severity. The majority of patients (n=136, 78%) showed AR post-TAVI before discharge and paravalvular AR (n=113, 83%) was more common than intravalvular AR (n=57, 42%). In particular, 47 (27%), 32 (18%) and 8 (5%) patients had significant (grade>2) overall, paravalvular and intravalvular AR, respectively. In terms of overall AR (Figure A), marked improvement was observed in patients with overall AR>2 (p<0.001), while no change was noted in patients with overall AR<2. Regarding paravalvular AR (Figure B), significant improvement was observed in patients with paravalvular AR>2 (p=0.002), while it remained unchanged in patients with AR<2. Concerning intravalvular AR (Figure C), no significant changes over time were seen in patients with intravalvular AR>2 or AR<2. Comparing patients with overall AR>2 (n=47) and AR<2 (n=128) before discharge on cardiac performance using echocardiography, no significant changes in left ventricular (LV) end-diastolic volume were noted over time in both groups (repeated ANOVA p>0.05), but improvement in LV ejection fraction and reduction in LV mass and left atrial volume were noted in both groups (repeated ANOVA p<0.05).
Conclusions: Significant paravalvular AR post-TAVI improved over time, while significant intravalvular AR remained unchanged. Improvement in LV ejection fraction and reduction in LV mass and left atrial volume were noted in all patients, regardless of the presence of significant AR before discharge.
- © 2012 by American Heart Association, Inc.