Valvular & structural heart disease
Incidence, Predictors, and Outcomes of Paravalvular Regurgitation After Transcatheter Aortic Valve Replacement (TAVR) in Sievers Type 1 Bicuspid Aortic Valves
Authors' conclusion
After TAVR with current-generation THVs in Sievers type 1 BAV stenosis, moderate or severe PVR occurred in about 4% of cases and was associated with an increased risk of MAEs during follow-up.
Study context
- Population
- Patients with Sievers type 1 bicuspid aortic valve (BAV) stenosis undergoing TAVR with current-generation transcatheter heart valves (THVs)
- Participants
- 946 patients
- Exposure
- Paravalvular regurgitation (PVR) grades after TAVR; moderate or severe PVR vs none/mild
- Mildn = 387
- Moderaten = 32
- Severen = 4
- Outcome
- Incidence of PVR (echocardiographic grading)
Methodological details24 international centres, consecutive patients
- 24 international centres
- Consecutive patients
Main finding
As reported in the abstract
PVR incidence
- Any PVR
- 423 (44.7%)
Observational data: associations, not effects.
Further findings
Independent predictors of moderate or severe PVR
| Comparison | Adjusted OR (95% CI) | |
|---|---|---|
| Larger virtual raphe ring perimeter | 1.07 (1.02–1.13) | |
| Severe annular or left ventricular outflow tract calcification | 5.21 (1.45–18.77) | |
| Self-expanding valve | 9.01 (2.09–38.86) | |
| Intentional supra-annular THV positioning | 3.31 (1.04–10.54) | |
| 0.050.21520Adjusted odds ratio (log scale) |
Original publication
Incidence, Predictors, and Outcomes of Paravalvular Regurgitation After TAVR in Sievers Type 1 Bicuspid Aortic Valves. JACC Cardiovasc Interv. Published 14 May 2024. doi:10. 1016/ j. jcin. 2024. 05. 002
Summarised from the published abstract; every number is checked against it