Paravalvular leak after CoreValve implantation in the Italian Registry: Predictors and impact on clinical outcome

摘要

Transcatheter aortic valve implantation (TAVI) is characterized by a high prevalence of post-procedural paravalvular leak (PVL), being moderate-to-severe in 5% to 40% of patients [1-6]. We previously identified moderate-to-severe PVL as an independent predictor of late mortality (>30 days up to 1 year) after Medtronic CoreValve implantation (Medtronic, Minneapolis, MN) in the Italian CoreValve Registry [3]. A dismal impact of PVL on medium-term prognosis has been recently demonstrated also for the Edwards SAPIEN prosthesis (Edwards Lifesciences, Irvine, California) [6]. Our aim was to evaluate the incidence and predictors of moderate-to-severe PVL after CoreValve implantation, and to assess its impact on 1-year mortality.Between June 2007 and December 2010, 984 consecutive patients were enrolled in the Italian CoreValve Registry [3,7]. In the present study we included the 821 patients who underwent successful TAVI and were followed-up for at least 1 year, excluding patients with procedural failure (n = 14), in-hospital death (n = 53), lack of echocardiographic assessment before discharge (n = 54), and lost to follow-up (n = 42).