Impact of Preprocedural Aortic Regurgitation in Patients with Paravalvular Leakage after TAVI

Objective: Paravalvular leakage (PVL) after transcatheter aortic valve implantation (TAVI) is known as a risk factor for mortality. Therefore, we aimed to investigate the impact of preprocedural aortic regurgitation (AR) in patients with PVL after TAVI.

Methods: From 2008 to 2016, 1060 consecutive patients were treated with a balloon expandable transcatheter valve in two centers. Out of them, 509 patients had a PVL ≥mild. These patients were divided into two groups according to the degree of preprocedural AR: none/trace AR (n = 180) and ≥mild AR (n = 329). Perioperative outcome was analyzed according to the VARC-II criteria. The influence of preprocedural aortic regurgitation on 30-day mortality and mortality in follow-up (median 720 days) was assessed using regression analysis.

Results: The mean age was 83 [IQR: 79–86] years. Beside aortic regurgitation, there was no significant difference in patient baseline characteristics between the two groups. We observed no significant difference in 30-day mortality (none/trace AR 4% vs. ≥mild AR 7%, p = 0.077), device success (none/trace AR 96% vs. ≥mild AR 97%, p = 0.434), early safety (none/trace AR 70% vs. ≥mild AR 73%, p = 0.607), stroke (none/trace AR 5% vs. ≥ mild AR 2%, p = 0.125) and myocardial infarction (none/trace AR 0% vs. ≥mild AR 0%, p = n.a.). Regression analysis revealed that the presence of preprocedural AR is not associated with decreased mortality in follow-up (median 720 days) in patients with PVL ≥mild.

Conclusion: The presence of preprocedural aortic regurgitation was not found to be a protective factor for survival in patients with paravalvular leakage after TAVI.