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You are here: Contents > 2016 > Volume 25 Number 2 March 2016 > AORTIC VALVE DISEASE > Aortic Regurgitation after TAVR: From Bad to Worse

Aortic Regurgitation after TAVR: From Bad to Worse

Nick Hiltrop1, Tom Adriaenssens1,2, Paul Herijgers2,3, Christophe Dubois2

1Department of Cardiovascular Medicine, University Hospitals Leuven, Leuven, 2Department of Cardiovascular Sciences, KU Leuven, Leuven, 3Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium

Transcatheter aortic valve replacement (TAVR) is a valuable alternative in surgical high-risk patients with symptomatic aortic valve stenosis. Here, the case is presented of very early transcatheter heart valve degeneration, probably caused by a ‘Venturi effect’ of a severe paravalvular regurgitant jet. This ultimately led to a leaflet being in the open position, creating severe valvular regurgitation that necessitated classical surgical revision. The occurrence of paravalvular regurgitation, and its known relationship with an adverse prognosis after TAVR, demonstrates the clear need for innovative alterations in valve design to prevent this complication.


Video 1: Angiography immediately after implantation of an Edwards SAPIEN 23 mm transcatheter heart valve, showing severe paravalvular aortic valve regurgitation. The implantation position is rather low.

Video 2: Transesophageal echocardiography with 2-D color imaging showing aortic valve long-axis view at 131°, three days after implantation of an Edwards SAPIEN 23 mm transcatheter heart valve. Severe eccentric paravalvular aortic valve regurgitation is shown without a significant valvular component. The implantation position is rather low.

Video 3: Transesophageal echocardiography with 2-D color imaging showing aortic valve long-axis view at 120°, one month after implantation of an Edwards SAPIEN 23 mm transcatheter heart valve. Severe combined valvular and paravalvular aortic valve regurgitation (grade 4/4) is shown.

The Journal of Heart Valve Disease 2016;25:182-184


Aortic Regurgitation after TAVR: From Bad to Worse

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