Paravalvular leak after transcatheter aortic valve implantation: trading one disease for another?

Abstract

Paravalvular leak is a common complication occurring after transcatheter aortic valve implantation and is associated with at least a 2-fold increase in 30-day and 1-year mortality risk. In high-risk, inoperable patients with severe aortic stenosis, paravalvular leak may even negate the survival benefit of transcatheter aortic valve implantation. This editorial reviews the anatomy, pathophysiology and predictors of paravalvular leak and discusses preventative and therapeutic strategies to optimally treat this previously underappreciated complication.

Keywords::

• aortic insufficiency
• complication
• mortality
• paravalvular leak
• transcatheter aortic valve implantation
• transcatheter aortic valve replacement

Financial & competing interests disclosure

MWA Chu has received grant support from the Canadian Institute of Health Research, Canadian Foundation for Innovation, Ontario Research Fund and AMOSO. The author has also received commercial research support from Neochordae, Inc. and Medtronic, Canada, and speaker's honorarium from Medtronic, Canada. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.