Paravalvular leak after transcatheter aortic valve implantation (TAVI): Short-term results. Data from Polish national POL-TAVI registry

Cardiol J. 2016;23(2):163-8. doi: 10.5603/CJ.a2015.0071. Epub 2015 Oct 27.

Abstract

Background: The authors analyzed data from Polish national POL-TAVI registry in terms of paravalvular leak (PVL) occurrence after transcatheter aortic valve implantation (TAVI) and its impact on clinical outcomes.

Methods: A total of 331 patients with severe aortic stenosis underwent TAVI (Edwards Sapien, n = 141; CoreValve, n = 190). The grade of PVL and survival rate were assessed at6-month follow-up.

Results: One hundred and eighty-one (54.7%) patients developed mild PVL, and 22 (6.6%) - moderate PVL after TAVI. No severe PVLs were observed. Occurrence of moderate PVL was device dependent and more frequent in the CoreValve group (p = 0.02). Larger CoreValve device used correlated with the grade of PVL (Spearman: r = 0.19; p = 0.01), but for Edwards Sapien devices this correlation was inverted (Spearman: r = -0.62; p = 0.01). Six-month mortality rate was not significant between patients with no or mild PVL compared to those with moderate PVL (p = 0.12).

Conclusions: The PVL occurrence remains a frequent problem after TAVI and is device de-pendent, more common with Edwards 23 mm valve and 31 mm CoreValve prosthesis.

Keywords: TAVI; aortic stenosis; high-risk patients; paravalvular leak.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aortic Valve / diagnostic imaging
  • Aortic Valve / surgery*
  • Aortic Valve Insufficiency / diagnosis
  • Aortic Valve Insufficiency / epidemiology
  • Aortic Valve Insufficiency / etiology*
  • Aortic Valve Stenosis / surgery*
  • Echocardiography, Transesophageal
  • Female
  • Follow-Up Studies
  • Heart Valve Prosthesis / adverse effects*
  • Humans
  • Incidence
  • Male
  • Poland / epidemiology
  • Postoperative Complications / epidemiology*
  • Registries*
  • Retrospective Studies
  • Survival Rate / trends
  • Time Factors
  • Transcatheter Aortic Valve Replacement / adverse effects*