ECHO 2013 / Evaluating the Post-Transcatheter Valve Patient
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Evaluating the Post-Transcatheter
Valve Patient
Philippe Pibarot, DVM, PhD, FACC, FAHA, FASE Canada Research Chair in Valvular Heart Diseases
INSTITUT UNIVERSITAIRE
DE CARDIOLOGIE
ET DE PNEUMOLOGIE
DE QUÉBEC
Université
LAVAL
Disclosure Statement
- Edwards Life Science: Research grant for
Echo Core Lab for assessment of transcatheter valve function
Suggestions for Timing of Echo Follow-up in TAVI
Preoprocedural
Predischarge /3-12 weeks
6 month
Annual echo follow-up
Doppler-Echo Evaluation of
Transcatheter Valves
Structural evaluation
2D/3D imaging of the shape and position of prosthesis stent
Cusps morphology and mobility
Functional evaluation
Courtesy of Dr R Hahn
Transprosthetic gradients, EOA, and Doppler velocity index
Localization (central vs. para) and degree of regurgitation
Structural Evaluation
Evaluation of Prosthesis Stent Position and Integrity
3.7 mm
Delayed (4 months) Valve Migration
10 mm
55 mmHg
Perforation of Anterior Mitral Valve
Masson et al. JACC Intv 2009;2:811–20)
Functional Evaluation
Transcatheter Valve Dysfunction:
- Valve EOA <1.1 cm2 and mean gradient ≥20 mmHg
AND/OR
-Moderate or severe prosthetic valve AR
Kappetein et al. Eur Heart J 2012