JACC: CARDIOVASCULAR INTERVENTIONS
VOL. 8, NO. 5, 2015
ª 2015 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION
ISSN 1936-8798/$36.00
PUBLISHED BY ELSEVIER INC.
http://dx.doi.org/10.1016/j.jcin.2014.11.027
IMAGES IN INTERVENTION
Overestimation of Paravalvular Leak With Edwards SAPIEN 3 Transcatheter Aortic Valve Replacement Taisei Kobayashi, MD, Jay Giri, MD, MPH, Prashanth Vallabhajosyula, MD, Howard C. Herrmann, MD, Dinesh H. Jagasia, MD
A
n 88-year-old woman with a history of
Transthoracic echocardiography performed the next
severe aortic stenosis presented for a trans-
day suggested severe PVL based on a >30% circum-
aortic valve replacement (TAVR). A pre-
ferential extent of PVL in the parasternal short-axis
TAVR computed tomography angiogram showed
(PSAX) view obtained just above the level of the
an aortic annular area of 385 mm 2 and an average
skirt of the SAPIEN 3 valve (Figure 1C, Online Video 2).
diameter of 22.1 mm (Figure 1A). The patient under-
However, the apical 3-chamber view and PSAX view
went an uncomplicated transfemoral #23 SAPIEN 3
obtained just below the level of the skirt showed only
valve
(Edwards
Lifesciences,
Irvine,
California)
implantation.
mild PVL (Figure 1D, Online Video 3 and Figure 1E, Online Video 4). The prominent circumferential dia-
The presence of a paravalvular leak (PVL) after
stolic color flow signal noted in the aortic root (at and
TAVR may be associated with increased mortality (1).
above the skirt of the SAPIEN 3 valve) may lead to
However, the assessment of paravalvular aortic
overestimation
regurgitation (AR) after TAVR is challenging. One
assessment of PVL must be done from multiple views.
of the widely used criteria for grading a PVL suggested
The evaluation of the circumferential extent of PVL
by the Valve Academic Research Consortium (VARC-2)
must be carefully performed below the aortic annulus
uses the circumferential extent of the prosthetic valve
and the skirt of the SAPIEN 3 valve to avoid over-
PVL (i.e.,
VOL. 8, NO. 5, 2015
ª 2015 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION
ISSN 1936-8798/$36.00
PUBLISHED BY ELSEVIER INC.
http://dx.doi.org/10.1016/j.jcin.2014.11.027
IMAGES IN INTERVENTION
Overestimation of Paravalvular Leak With Edwards SAPIEN 3 Transcatheter Aortic Valve Replacement Taisei Kobayashi, MD, Jay Giri, MD, MPH, Prashanth Vallabhajosyula, MD, Howard C. Herrmann, MD, Dinesh H. Jagasia, MD
A
n 88-year-old woman with a history of
Transthoracic echocardiography performed the next
severe aortic stenosis presented for a trans-
day suggested severe PVL based on a >30% circum-
aortic valve replacement (TAVR). A pre-
ferential extent of PVL in the parasternal short-axis
TAVR computed tomography angiogram showed
(PSAX) view obtained just above the level of the
an aortic annular area of 385 mm 2 and an average
skirt of the SAPIEN 3 valve (Figure 1C, Online Video 2).
diameter of 22.1 mm (Figure 1A). The patient under-
However, the apical 3-chamber view and PSAX view
went an uncomplicated transfemoral #23 SAPIEN 3
obtained just below the level of the skirt showed only
valve
(Edwards
Lifesciences,
Irvine,
California)
implantation.
mild PVL (Figure 1D, Online Video 3 and Figure 1E, Online Video 4). The prominent circumferential dia-
The presence of a paravalvular leak (PVL) after
stolic color flow signal noted in the aortic root (at and
TAVR may be associated with increased mortality (1).
above the skirt of the SAPIEN 3 valve) may lead to
However, the assessment of paravalvular aortic
overestimation
regurgitation (AR) after TAVR is challenging. One
assessment of PVL must be done from multiple views.
of the widely used criteria for grading a PVL suggested
The evaluation of the circumferential extent of PVL
by the Valve Academic Research Consortium (VARC-2)
must be carefully performed below the aortic annulus
uses the circumferential extent of the prosthetic valve
and the skirt of the SAPIEN 3 valve to avoid over-
PVL (i.e.,
