Author + information
- Received December 21, 2014
- Revision received January 22, 2015
- Accepted January 25, 2015
- Published online March 1, 2015.
- Philippe Pibarot, DVM, PhD∗∗ (, )
- Rebecca T. Hahn, MD†,
- Neil J. Weissman, MD‡ and
- Mark J. Monaghan, PhD§
- ∗Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Department of Medicine, Laval University, Québec, Canada
- †Department of Medicine, Columbia University Medical Center/NY Presbyterian Hospital, New York, New York
- ‡Department of Medicine, Medstar Health Research Institute and Georgetown University, Washington, DC
- §Department of Cardiology, King’s College Hospital, London, United Kingdom
- ↵∗Reprint requests and correspondence:
Dr. Philippe Pibarot, Institut Universitaire de Cardiologie et de Pneumologie de Québec, 2725 Chemin Sainte-Foy, Québec G1V-4G5, Canada.
Paravalvular regurgitation (PVR) is a frequent complication of transcatheter aortic valve replacement that has been shown to be associated with increased mortality. The objective of this article is to review the most up-to-date information about the assessment and management of PVR and to propose a new more comprehensive and unifying scheme for grading PVR severity. A multimodality, multiparametric, integrative approach including Doppler echocardiography, cineangiography, hemodynamic assessment, and/or cardiac magnetic resonance is essential to accurately assess the severity of PVR and the underlying etiology. Corrective procedures such as balloon post-dilation, valve-in-valve, or leak closure may be considered, depending on the severity, location, and etiology of PVR.
- aortic regurgitation
- aortic stenosis
- cardiac magnetic resonance
- Doppler echocardiography
- transcatheter aortic valve replacement
- transcatheter heart valve
Dr. Pibarot holds the Canada Research Chair in Valvular Heart Disease, and his research program is funded by the Canadian Institutes of Health Research (grant numbers: MOP 126072, MOP 114997; MOP 102737). Dr. Pibarot has Core Lab contracts with Edwards Lifesciences, for which he receives no direct compensation; and is a speaker for St. Jude Medical. Dr. Hahn has Core Lab contracts with Edwards Lifesciences for which she receives no direct compensation and is a speaker for Philips Healthcare, St. Jude Medical, and Boston Scientific. Dr. Weissman has Core Lab contracts with Edwards Lifesciences, St. Jude Medical, Boston Scientific, Medtronic, Biostable, Sorin, Abbott Vascular, Direct Flow, and Mitralign, for which he receives no direct compensation. Dr. Monaghan is proctor for Edwards Lifesciences; and is a speaker for Philips Medical Systems and GE Medical.
- Received December 21, 2014.
- Revision received January 22, 2015.
- Accepted January 25, 2015.
- American College of Cardiology Foundation