Association of postprocedural aortic regurgitation with mitral regurgitation worsened after transcatheter aortic valve replacement

2017 ◽  
Vol 35 (3) ◽  
pp. 346-352
Author(s):  
Kentaro Shibayama ◽  
Hirotsugu Mihara ◽  
Javier Berdejo ◽  
Kenji Harada ◽  
Robert J. Siegel ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Mitral Regurgitation ◽  
Aortic Valve Replacement ◽  
Aortic Regurgitation ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Transcatheter Aortic Valve

Complex transcatheter aortic valve replacement in aortic regurgitation and transcatheter mitral annuloplasty in severe dextrocardia

2021 ◽  
Author(s):  
Piotr Nikodem Rudziński ◽  
Markus Mach ◽  
Christoph Gross ◽  
Martin Andreas
Keyword(s):  
Aortic Valve ◽  
Mitral Regurgitation ◽  
Aortic Valve Replacement ◽  
Aortic Regurgitation ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Valve Repair ◽  
Transcatheter Aortic Valve ◽  
Transcatheter Mitral Valve Repair ◽  
Secondary Mitral Regurgitation

Abstract A 70-year-old female with symptomatic severe native aortic regurgitation, acquired dextrocardia, moderate-to-severe secondary mitral regurgitation and prohibitive surgical risk was admitted for transcatheter aortic valve replacement. A balloon-expendable Sapien 3 Ultra valve was implanted successfully. After 6 months, the patient remained symptomatic due to the concomitant moderate-to-severe secondary mitral regurgitation. Transcatheter mitral valve repair using a Carillon Mitral Contour System was performed resulting in a significant reduction of mitral regurgitation and uneventful follow-up. Most importantly, other transcatheter repair techniques would not have been feasible due to the impossible transoesophageal echocardiography guidance. This is the first case of transcatheter aortic valve replacement in a patient with native aortic regurgitation, acquired dextrocardia and severe aortic annulus malrotation using a balloon-expendable valve. Moreover, it is the first transcatheter mitral valve repair procedure using Carillon device performed by a cardiac surgeon.

Abstract 12320: Assessment of Post-Procedural Aortic Regurgitation After Transcatheter Aortic Valve Replacement During the Procedure: An Intraprocedural Transesophageal Echocardiography Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Hirotsugu Mihara ◽  
Kentaro Shibayama ◽  
Hasan Jilaihawi ◽  
Yuji Itabashi ◽  
Javier Berdejo ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Transesophageal Echocardiography ◽  
Aortic Regurgitation ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Color Doppler ◽  
Descending Aorta ◽  
Transcatheter Aortic Valve ◽  
Pulsed Wave Doppler

Introduction: The assessment of post-procedual aortic regurgitation (PAR) after transcatheter aortic valve replacement (TAVR) has not been validated. The purpose of this study was (1) to investigate the value of holodiastolic flow reversal (HDFR) in the descending aorta in patients with PAR after TAVR and (2) to determine which color Doppler parameters are useful for PAR grading using the intraprocedural transesophageal echocardiography (iTEE). Hypothesis: We hypothesized that HDFR in the descending aorta and any color Doppler parameters can delineate significant PAR after TAVR. Methods: Three hundred-eighty patients with severe aortic stenosis underwent TAVR with the Edwards SAPIEN valve with 131 pulsed-wave Doppler tracings from the descending aorta had assessed by iTEE. PAR was evaluated using 2D color Doppler by the cross-sectional area of the vena contracta (VCA) at the aortic annular plane, and by the longitudinal jet extent (mosaic signals, Figure A) compared to the location of the tip of the anterior mitral leaflet (AML). Significant PAR was defined as VCA of ≥10 mm2, corresponding to greater than a moderate grade. Results: In patients with any grade of PAR, pulsed-wave Doppler tracing from the descending aorta, jet extent and VCA were obtained in 100%, 80%, and 74%, respectively. All patients with consistent HDFR had significant PAR. By multivariate analysis, a consistent HDFR and jet extent beyond the tip of AML were independent predictors of significant PAR. A consistent HDFR and jet extent beyond the tip of AML predicted significant PAR with specificity of 100% and 97%, respectively. In the other hand, patients with both negative HDFR and jet extent of less than halfway to the tip of AML had no significant PAR with a 97% specificity. Conclusions: The presence of HDFR with each cardiac cycle and jet extent beyond the tip of AML are indicative of significant PAR.

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