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Periprosthetic aortic valve regurgitation — Clinical Guidelines

Overview

The provided abstracts primarily focus on procedural aspects and complications of transcatheter aortic valve replacement (TAVR) and balloon aortic valvuloplasty (BAV), specifically temporary pacing modalities and permanent pacemaker implantation rates associated with different valve types. They do not directly address periprosthetic aortic valve regurgitation.

Key Recommendations

Left ventricular pacing (LVP) is a safer and more efficacious temporary pacing modality during TAVR and balloon aortic valvuloplasty (BAV) compared to right ventricular pacing (RVP) 1. (Evidence: Strong)

LVP is associated with significantly lower short-term mortality, reduced incidence of cardiac tamponade, shorter hospital stays, and decreased procedure duration compared to RVP during TAVR/BAV 1. (Evidence: Strong)

New permanent pacemaker implantation rates are lower with LVP compared to RVP following TAVR/BAV 1. (Evidence: Strong)

Permanent pacemaker implantation (PPI) rates following transcatheter aortic valve implantation (TAVI) vary significantly based on the type of transcatheter heart valve used 2. (Evidence: Strong)

Balloon-expandable valves (BEV) and self-expandable valves (SEV) are associated with lower post-TAVI PPI rates compared to mechanically expandable valves (MEV) 2. (Evidence: Strong)

Among specific transcatheter heart valves, Acurate Neo and similar devices showed the lowest pooled PPI rate, while Lotus valves were associated with the highest pooled PPI rate 2. (Evidence: Strong)

References

1 Khalefa BB, Ayyad M, Albandak M, Ayyad A, Yassin MNA, Awad AK. Left versus right ventricular pacing during TAVR and balloon aortic valvuloplasty: A systematic review and meta-analysis. Pacing and clinical electrophysiology : PACE 2024. link 2 Ravaux JM, Di Mauro M, Vernooy K, Kats S, Mariani S, Ronco D et al.. Permanent pacemaker implantation following transcatheter aortic valve implantation using self-expandable, balloon-expandable, or mechanically expandable devices: a network meta-analysis. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 2021. link

Periprosthetic aortic valve regurgitation

Overview

Key Recommendations

References

Original source