Objectives:To study the course of aortic regurgitation (intra or perivalvular) in native aortic stenosis patients following TAVI, and its impact on clinical outcome.
Methods: We studied 126 patients who underwent TAVI between 2008 and 2013 at our medical center, and had clinical and echocardiographic assessment at both 1 and 6 months post procedural period. AR wasassessed qualitatively by standard color Doppler echocardiographic criteria. The effect of TAVI on clinical outcome was assessed by comparing NYHA class before, at 1, and 6 month post procedure.
Results:126 patients who underwent TAVI had echocardiographic follow-up imaging and were included in the current analysis. The prevalence of mild, moderate and severe AR was 86.5%, 12.7%, 0.6% at 1 month and 84.9%, 13.7%, 1.4% at 6 monthsrespectively. In 97/126 (77%) patients with AR, there was no significant change in the degree of AR, 16 (13%) patients had AR worsening (14 patients from mild to moderate, one from mild to severe, and one from moderate to severe), and in 13 (10%) patients the AR improved (12 from moderate to mild, and 1 from severe to mild AR) (p=0.764). There was a significant improvement in the NYHA Class pre procedure, at 1 and 6 months post TAVI. Prior to TAVI, 66 patients were in NYHA IV and 112 were in NYHA III. After 6 months no patient was in NYHA IV as the vast majority of patients were in NYHA I/II (p<0.001).
Conclusion: In our experience, moderate AR or more following TAVI is infrequent. Despite some individual changes in AR severity, there was no significant overall change in the degree of AR between 1 and 6 months following TAVI. At 6 months follow up most patients improved clinically, implicating a modest effect of theresidual AR on functional class.
