Valvular & structural heart disease
Treatment of late paravalvular regurgitation after transcatheter aortic valve implantation: prognostic implications
Authors' conclusion
This study describes the efficacy of transcatheter treatments for PVR after TAVI. Patients in whom PVR was successfully reduced had better prognosis.
Study context
- Population
- Patients undergoing transcatheter intervention for ≥ moderate paravalvular regurgitation (PVR) after index transcatheter aortic valve implantation (TAVI)
- Participants
- 201 patients
- Exposure
- Redo-TAVI vs plug closure vs balloon valvuloplasty for PVR after TAVI
- Redo-TAVIn = 87
- Plugn = 79
- Valvuloplastyn = 35
- Outcome
- Residual aortic regurgitation (AR) and mortality
- Follow-up
- 1 year after PVR treatment
Methodological detailsmulticentre, 22 centres, consecutive patients, Median TAVI-to-re-intervention time 207 (35; 765) days, Failed valve self-expanding in 129 (63.9%)
- Multicentre
- 22 centres
- Consecutive patients
- Median TAVI-to-re-intervention time 207 (35; 765) days
- Failed valve self-expanding in 129 (63.9%)
Main finding
As reported in the abstract
Mortality · 1 year
- Overall 1-year mortality
- 29 (14.4%)
- Between-strategy difference
- P = 0.418
Observational data: associations, not effects.
Further findings
AR ≥ moderate persisting · 30 days
| Outcome | Redo-TAVI | Plug | Valvuloplasty | P value |
|---|---|---|---|---|
| Mortality · 30 days | 0 events | 10.1% | 5.7% | |
| 1-year mortality by AR reduced to ≤ mild vs persisting ≥ moderateRegardless of treatment strategy | P = 0.007 |
- Aortic regurgitation (AR) ≥ moderate persisting — Overall
- 33 (17.4%)
- AR ≥ moderate persisting — Between-strategy difference
- P = 0.036
- Mortality — Overall
- 10 (5.0%)
- Mortality — Between-strategy difference
- P = 0.010
- 1-year mortality by AR reduced to ≤ mild vs persisting ≥ moderate: AR ≤ mild 8.0%
- 1-year mortality by AR reduced to ≤ mild vs persisting ≥ moderate: AR ≥ moderate 21.4%
Original publication
Treatment of late paravalvular regurgitation after transcatheter aortic valve implantation: prognostic implications. Eur Heart J. Published 22 March 2023. doi:10.
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