Assessment of prosthetic valve function and para-valvular regurgitation after trans-catheter aortic valve replacement

PURPOSE OF REVIEW: To review the current literature on prosthetic valve function and para-valvular regurgitation (PVR) after trans-catheter aortic valve replacement (TAVR). TAVR is a new alternative for the treatment of severe aortic stenosis in patients at high risk for surgical aortic valve replacement and nonsurgical candidates. RECENT FINDINGS: The innovations in three-dimensional trans-esophageal echocardiography have made it an integral part of the TAVR procedure. PVR is more frequent with TAVR than surgical aortic valve replacement and is associated with worse cardiovascular outcomes. Recent publications focus on echocardiographic techniques to better assess the structural components of aortic valve complex, and begin to define the mechanism and risks of PVR after TAVR. SUMMARY: Imaging innovations before, during, and after TAVR may lead to improved patient selection, accelerated development of TAVR prostheses, and ultimately a fuller characterization of the performance and potential limitations of a new generation of prosthetic heart valves.