Am J Cardiovasc Dis 2011;1(3):312-320
Review Article
Valvular leak after transcatheter aortic valve implantation: a clinician update
on epidemiology, pathophysiology and clinical implications
Giuseppe Tarantini, Valeria Gasparetto, Massimo Napodano, Chiara Fraccaro, Gino Gerosa, Giambattista Isabella
Cardiology Division and Cardiac Surgery, Department of Cardiac, Thoracic and Vascular Sciences. University of Padua
Medical School, Padua, Italy.
Received July 29, 2011; accepted August 30, 2011; Epub September 10, 2011; published September 30, 2011
Abstract: During trascatheter aortic valve implantation (TAVI) the native valve is not removed but crushed. Thus, a slight
prosthesis insufficiency is not uncommon and has been reported in about 70% of patients for both available types of
percutaneous valves. However, the definition of clinically “significant” valve regurgitation is not fully established yet. In most
cases, aortic insufficiency is mild and clinical acceptable, however, severe insufficiency can occur. Paravalvular
insufficiency is usually prevalent, and it may be the consequence of prosthesis/patient mismatch due to an undersizing of
the implanted device or to an incomplete expansion of the prosthesis stent frame, or also to incorrect site of prosthesis
implantation. Thus, an accurate assessment of the aortic valve annulus before TAVI is mandatory in order to select the
optimal size of the valve. The presence of large calcium burden or bicuspid valve as well as the correct implantation of the
device are other key determinants of final valve insufficiency. When severe regurgitation is present, an integration of
hemodynamic, angiographic, transthoracic and TEE data is necessary to tailor the best clinical decision on a per-patient
basis. (AJCD1107007).
Keywords: Valvular leak, transcatheter aortic valve implantation
Full Text PDF
Address all correspondence to:
Giuseppe Tarantini, MD, PhD
Division of Cardiology, Department of Cardiac
Thoracic and Vascular Sciences
Policlinico Universitario
Via Giustiniani, 2, 35128 Padova, Italy.
Tel: +39 049 8211844; Fax: +39 049 8761764
E-mail: giuseppe.tarantini.1@unipd.it
Review Article
Valvular leak after transcatheter aortic valve implantation: a clinician update
on epidemiology, pathophysiology and clinical implications
Giuseppe Tarantini, Valeria Gasparetto, Massimo Napodano, Chiara Fraccaro, Gino Gerosa, Giambattista Isabella
Cardiology Division and Cardiac Surgery, Department of Cardiac, Thoracic and Vascular Sciences. University of Padua
Medical School, Padua, Italy.
Received July 29, 2011; accepted August 30, 2011; Epub September 10, 2011; published September 30, 2011
Abstract: During trascatheter aortic valve implantation (TAVI) the native valve is not removed but crushed. Thus, a slight
prosthesis insufficiency is not uncommon and has been reported in about 70% of patients for both available types of
percutaneous valves. However, the definition of clinically “significant” valve regurgitation is not fully established yet. In most
cases, aortic insufficiency is mild and clinical acceptable, however, severe insufficiency can occur. Paravalvular
insufficiency is usually prevalent, and it may be the consequence of prosthesis/patient mismatch due to an undersizing of
the implanted device or to an incomplete expansion of the prosthesis stent frame, or also to incorrect site of prosthesis
implantation. Thus, an accurate assessment of the aortic valve annulus before TAVI is mandatory in order to select the
optimal size of the valve. The presence of large calcium burden or bicuspid valve as well as the correct implantation of the
device are other key determinants of final valve insufficiency. When severe regurgitation is present, an integration of
hemodynamic, angiographic, transthoracic and TEE data is necessary to tailor the best clinical decision on a per-patient
basis. (AJCD1107007).
Keywords: Valvular leak, transcatheter aortic valve implantation
Full Text PDF
Address all correspondence to:
Giuseppe Tarantini, MD, PhD
Division of Cardiology, Department of Cardiac
Thoracic and Vascular Sciences
Policlinico Universitario
Via Giustiniani, 2, 35128 Padova, Italy.
Tel: +39 049 8211844; Fax: +39 049 8761764
E-mail: giuseppe.tarantini.1@unipd.it
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