ECHO 2013 / Evaluating the Post-Transcatheter Valve Patient
.pdf
Quantification of Transcatheter Valve
Regurgitation
Zoghbi et al. J Am Soc Echocardiogr, 22:975-1014, 2009 Pibarot & Dumesnil, Heart, 98:69-78, 2012
Grading Severity of Paravalvular
Regurgitation
Mild (<10%)
Moderate
(10-20%)
Severe (>20%)
Bloomfield; JACC Img;
5:441–55, 2012
PARTNER-A 2-Year Outcomes:
Prosthetic Valve Regurgitation
Paravalvular Regurgitation |
Total (Paravalvular+Central) |
|
Regurgitation |
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Kodali et al.; NEJM 2012
Optimal Cut-Plane
for Central
Regurgitation?
a.Lower Stent
b.Pre-stent
c.LVOT
Optimal Cut-Plane
for Paravalvular
Regurgitation?
a.Lower stent
b.Pre-stent
c.LVOT
Optimal Cut-Plane
for PVAR in Self-
Expendable Valves
a. Mid-Stent 
b. Lower Stent
c. LVOT
How to change a PVAR from mild to moderate…
Case #1
1. Mild (<10%)
2. Moderate (10-29%)
3. Severe (≥30%)
Case #2
1. Mild (<10%)
2. Moderate (10-29%)
3. Severe (≥30%)