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How to Image and Manage Prosthesis-Related Complications After Transcatheter Aortic Valve Replacement

  • Structural Heart Disease (RJ Siegel and NC Wunderlich, Section Editors)
  • Published:
Current Cardiology Reports Aims and scope Submit manuscript

Abstract

Purpose of review

In this review, we provide an overview of potential prosthesis — related complications after transcatheter aortic valve replacement, their incidences, the imaging modalities best suited for detection, and possible strategies to manage these complications.

Recent findings

Therapy for severe aortic valve stenosis requiring intervention has increasingly evolved toward transcatheter aortic valve replacement over the past decade, and the number of procedures performed has increased steadily in recent years. As more and more centers favor a minimalistic approach and largely dispense with general anesthesia and intra-procedural imaging by transesophageal echocardiography, post-procedural imaging is becoming increasingly important to promptly detect dysfunction of the transcatheter valve and potential complications.

Summary

Complications after transcatheter aortic valve replacement must be detected immediately in order to initiate adequate therapeutic measures, which require a profound knowledge of possible complications that may occur after transcatheter aortic valve replacement, the imaging modalities best suited for detection, and available treatment options.

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Abbreviations

2D:

Two-dimensional

3D:

Three-dimensional

AR:

Aortic regurgitation

AS:

Aortic stenosis

BEV:

Balloon-expandable valve

CCT:

Cardiac computed tomography

CMR:

Cardiac magnetic resonance

DMR:

Degenerative mitral regurgitation

ECG:

Electrocardiogram

EROA:

Effective regurgitant orifice area

FMR:

Functional mitral regurgitation

HALT:

Hypo-attenuating leaflet thickening

IE:

Infective endocarditis

LVOT:

Left ventricular outflow tract

LV:

Left ventricle

MDCT:

Multidetector computed tomography

MR:

Mitral regurgitation

PPM:

Prosthesis-patient mismatch

PVL:

Paravalvular leak

SAVR:

Surgical aortic valve replacement

SEV:

Self-expanding valve

TAV:

Transcatheter aortic valve

TAVR:

Transcatheter aortic valve replacement

TEE:

Transesophageal echocardiography

TTE:

Transthoracic echocardiography

VARC:

Valve Academic Research Consortium

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Wunderlich, N.C., Honold, J., Swaans, M.J. et al. How to Image and Manage Prosthesis-Related Complications After Transcatheter Aortic Valve Replacement. Curr Cardiol Rep 23, 94 (2021). https://doi.org/10.1007/s11886-021-01522-2

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