Background: Transcatheter Aortic Valve Replacements (TAVR) has become widespread throughout the world. To date there are no echocardiographic study of TAVR patients from Southeast Asia (SEA). We sought to evaluate 1) changes in echocardiographic and strain values pre and post TAVR 2) relationship between aortic stenosis (AS) severity and strain values, 3) left ventricle geometry in severe AS 4) relationship of flow rate to dimensionless index (DVI) and acceleration time (AT) and 5) effect of strains on outcome. Methods: Retrospective study of 112 TAVR patients in our center from 2009 to 2020. The echocardiographic and strain images pre (within 1 months), post (day after) and 6 months post TAVR were analyzed by expert echocardiographer. Results: The ejection fraction (EF) increased at 6 months (53.02 ± 12.12% to 56.35 ± 9.00%) (p=0.044). Interventricular septal thickness in diastole (IVSd) decreased (1.27 ± 0.21cm to 1.21 ± 0.23cm) (p=0.038) and left ventricle internal dimension in diastole (LVIDd) decreased from 4.77 ± 0.64cm to 4.49 ± 0.65cm (p = 0.001). No changes in stroke volume index (SVI pre vs 6 months p =0.187), but the flow rate increases (217.80 ± 57.61mls/s to 251.94 ± 69.59mls/s, p<0.001). Global Longitudinal Strain (GLS) improved from -11.44 ± 4.23% to -13.94 ± 3.72% (p <0.001), Left Atrial Reservoir strain (Lar-S) increased from 17.44 ± 9.16% to 19.60 ± 8.77% (p=0.033). 8 patients (7.5%) had IVSd < 1.0cm, and 4 patients (3.7%) had normal left ventricle (LV) geometry. There was linear relationship between IVSd and mean PG (r=0.208, p=0.031), between GLS to aortic valve area (AVA) and aortic valve area index (AVAi) (r = – 0.305, p=0.001 and r= – 0.316, p = 0.001). There was also relationship between AT (r=-0.20, p=0.04) and DVI (r=0.35, p< 0.001) with flow rate. Patients who died late (after 6 months) had lower GLS at 6 months. (Alive; -13.94 ± 3.72% vs Died; -12.43 ± 4.19%, p= 0.001) Conclusion: At 6 months TAVR cause reverse remodeling of the LV with reduction in IVSd, LVIDd and improvement in GLS and LAr-S. There is linear relationship between GLS and AVA and between IVSd and AVA.

Background: Transcatheter tricuspid valve intervention has recently emerged as a viable alternative to surgery for patients with symptomatic severe tricuspid regurgitation (TR). Though usually performed on the basis of compassionate grounds, we are now exploring the extension of its usage as an elective option in a patient with severe atrial functional tricuspid regurgitation. Aims:The aim of this study was to select a suitable patient and proceed with the implantation of the TricValve in order to provide symptomatic relief as well as to improve morbidity and mortality.Methods: A 67-year-old woman had underlying atrial fibrillation and severe tricuspid regurgitation.Despite optimised medical therapy, she remained symptomatic with elevated NT-proBNP levels. As the patient refused surgery on multiple occasions, we chose a percutaneous procedure guided by transoesophageal echocardiography and fluoroscopy.

No abstract

No abstract

No abstract