Table 4

VARC II Recommendations for Evaluation of Aortic and/or Paravalvular Regurgitation After TAVR

MildModerateSevere
Semiquantitative parameters
 Diastolic flow reversal in the descending aorta—pulsed waveAbsent or brief early diastolicIntermediateProminent, holodiastolic
 Circumferential extent of prosthetic valve paravalvular regurgitation (%)<1010–29≥30
Quantitative parameters
 Regurgitant volume (ml/beat)<3030–59≥60
 Regurgitant fraction (%)<3030–49≥50
 Effective regurgitant orifice area (cm2)0.100.10–0.29≥0.30

Adapted with permission from Kappetein et al. (66).

VARC = Valve Academic Research Consortium; other abbreviations as in Table 1.

  • Not well validated and may overestimate severity compared with quantitative Doppler.

  • For LVOT >2.5 cm, significant stenosis criteria is <0.20.