Three‐dimensional echocardiography in the evaluation and management of paravalvular regurgitation

Abstract

Paravalvular regurgitation is an uncommon but serious complication that can be encountered after either surgical or percutaneous valve replacement and is associated with increased morbidity and mortality. Early detection and accurate assessment of paravalvular regurgitation are crucial to identify those who would benefit from intervention. Recent advances in 3‐dimensional echocardiography have increased the feasibility of percutaneous approaches for the management of paravalvular regurgitation. Percutaneous closure of paravalvular regurgitation has emerged as a favorable alternative for redo surgery in selected cases. This article will review the role of 3‐dimensional echocardiography in the assessment and management of paravalvular regurgitation.

Three‐dimensional echocardiographic assessment of the aortic valve and the aorta

“…3D measurement of VCA is simple and correlates very well with MRI method 25 . Noteworthy, the incremental value of 3D echocardiography is invaluable in the evaluation of patients with prosthetic aortic valve regurgitation 26 . The use of color 3D TEE allows for accurate assessment of paravalvular regurgitation site, size, and severity.…”

“…25 Noteworthy, the incremental value of 3D echocardiography is invaluable in the evaluation of patients with prosthetic aortic valve regurgitation. 26 The use of color 3D TEE allows for accurate assessment of paravalvular regurgitation site, size, and severity. In addition, live 3D TEE is used to guide percutaneous paravalvular leak closure (Figure 5, Video 4).…”

Application of and Prospects for 3-Dimensional Printing in Transcatheter Mitral Valve Interventions

“…When the leak is small and the guide wire is difficult to reach, the X-ray exposure time and the amount of radiation are increased significantly. TEE may accurately note the location of the PVL and quantitatively evaluate the severity, but the presence of artifacts often makes it is difficult to judge accurately the size of the leak [ 71 ]. Preoperative CTA evaluation may help determine the shape and size of the PVL.…”