Table 1

Selected Publications Reporting AR After TAVR

First Author, Year (Ref. #)nApproachProsthesisImaging ModalitySeverity GradationAdjunctive TechniquesAR Post-TAVRPredictors of AR by Multivariable Analysis
Detaint, 2009 (10)74
  • TF = 46 (62%)

  • TA = 28 (38%)

ES
  • Echocardiogram (TEE)

  • Site reported (blinded echocardiographist)

  • 0 = absent

  • 1 = trace/mild

  • 2 = mild/moderate

  • 3 = moderate/severe

  • 4 = severe

  • Post-dilation = 5/74

  • Valve-in-valve = 2/74

  • Early post-TAVR (TEE)

  • 0 = 5 (7.0%)

  • 1 = 53 (72.0%)

  • 2 = 12 (16.0%)

  • 3 = 4 (5.0%)

  • 4 = 0 (0%)

  • ≥2/4 AR

  • • Low cover index

  • • Operator's experience

Abdel-Wahab, 2011 (3)690
  • TF = 644

  • TA = 26

  • SC = 22

  • TAo = 5

  • ES = 110 (16%)

  • MCV = 580 (84%)

  • Angiogram

  • Site reported

  • 0 = absent

  • 1 = trace/mild

  • 2 = mild/moderate

  • 3 = moderate/severe

  • 4 = severe

  • Early post-TAVR (angiogram)

  • 0 = 191 (27.7%)

  • 1 = 380 (55.1%)

  • 2 = 103 (14.9%)

  • 3 = 14 (2.0%)

  • 4 = 2 (0.3%)

  • ≥2/4 AR

  • • AVA baseline

  • • Annulus baseline

  • • Cardiogenic shock

  • • Renal failure

  • • Male

Sherif, 2010 (14)50TFMCV
  • Angiogram

  • Echocardiogram

  • Site reported

  • 1 = trivial/mild

  • 2 = moderate

  • 3 = moderate/severe

  • 4 = severe

  • Early post-TAVR (angiogram)

  • 0 = 3 (6.0%)

  • 1 = 27 (54.0%)

  • 2 = 13 (26.0%)

  • 3 = 7 (14.0%)

  • 4 = 0 (0%)

  • Early post-TAVR (TTE)

  • 0 = 9 (18.0%)

  • 1 = 24 (48.0%)

  • 2 = 13 (26.0%)

  • 3 = 4 (8%)

  • 4 = 0 (0%)

  • ≥2/4 AR

  • • Increase angle of LVOT and ascending aorta

  • • Depth of device in relation to noncoronary cups

John, 2010 (78)100
  • TF = 97 (97%)

  • SC = 3 (3%)

MCV
  • Angiogram

  • Echocardiogram

  • 0

  • 1+

  • 2+

  • 3+

  • 4+

  • Post-dilation = 34/100

  • Snare technique = 4/100

  • Valve-in-valve = 3/100

  • Early post-TAVR (angiogram)

  • 0 = 35 (35.4%)

  • 1+ = 28 (28.3%)

  • 2+ = 19 (19.2%)

  • 3+ = 8 (0.8%)

  • 4+ = 0 (0%)

  • Early after adjunctive technique (angiogram)

  • 0 =38 (38.4%)

  • 1+ = 49 (49.5%)

  • 2+ = 11 (11.1%)

  • 3+ = 1 (0.1%)

  • 4+ = 0 (0%)

AgS and DLZ-CS showed significant correlation with grade of PVL after initial MCV deployment
Takagi, 2011 (15)79
  • TF = 62 (78.5%)

  • SC = 17 (21.5%)

MCV
  • Angiogram

  • Echocardiogram

  • Site reported

  • 0 = absent

  • 1 = mild

  • 2 = moderate

  • 3–4 = severe

  • Post-dilation = 21/79

  • Snare technique = 1/79

  • Valve-in-valve = 2/79

  • Final result (angiogram)

  • 0 = 21 (26.6%)

  • 1 = 42 (53.2%)

  • 2 = 13 (16.5%)

  • 3 = 3 (3.8%)

  • 4 = 0 (0%)

  • ≥2/4 AR

  • • Larger annulus diameter

  • • Low implantation

  • • Peripheral vascular disease

Tamburino, 2011 (6)663TFMCV
  • Echocardiogram

  • Site reported, events reviewed by independent CEC

  • Post-dilation = 68/663

  • Valve-in-valve = 139/663

  • Conversion to open surgery = 5/663

  • Post-TAVR

  • ≥2 PVL = 139 (21.0%)

Gotzmann, 2011 (4)145TF/SCMCV
  • Echocardiogram

  • Angiogram (If poor TTE quality)

  • Site reported

  • Mild

  • Moderate

  • Severe

  • Early post-TAVR

  • Mild = 64 (44%)

  • Moderate = 23 (16%)

  • Severe = 2 (1%)

  • Early post-TAVR

  • 30-day survivors only

  • Mild = 55 (45%)

  • Moderate = 16 (13%)

  • Severe = 0 (0%)

Moat, 2011 (5)870
  • TF = 599

  • Other = 271

  • ES = 410 (47%)

  • MCV = 459 (53%)

  • Angiogram

  • Site reported

Conversion to open surgery = 6/850
  • AR ≥1 = 516 (61%)

  • AR >2 = 115 (13.6%)

AgS = Agatston score; AR = aortic regurgitation; AVA = aortic valve replacement; CEC = clinical events committee; DLZ-CS = device-landing zone calcification score; ES = Edwards Sapien; LVOT = left ventricular outflow track; MCV = Medtronic CoreValve; PVL = paravalvular leak; SC = subclavian; TA = transapical; TAo = transaortic; TAVR = transcatheter aortic valve replacement; TEE = transesophageal echocardiography; TF = transfemoral; TTE = transthoracic echocardiography.