Trial reportEuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology2022
Paravalvular regurgitation after transcatheter aortic valve replacement in intermediate-risk patients: a pooled PARTNER 2 study.
Trial report in EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
24 citing papers in PubMed.
- Echocardiographic Results of Transcatheter Versus Surgical Aortic Valve Replacement in Women With Severe Aortic Stenosis: The RHEIA Trial.Journal of the American Heart Association · 2026Trial
- Diastolic delta best predicts paravalvular regurgitation after transcatheter aortic valve replacement as assessed by cardiac magnetic resonance: the APPOSE trial.European heart journal. Cardiovascular Imaging · 2023Trial
- Contemporary Management of Aortic Stenosis: Timing of Intervention and Lifetime Valve Management.European journal of clinical investigation · 2026Review
- Early Echocardiographic Changes Following Transcatheter Aortic Valve Implantation: A Comparative Analysis of Different Transcatheter Aortic Valve Systems.Journal of cardiovascular development and disease · 2026Article
- Joint aortic root segmentation and landmark localization on intraoperative fluoroscopy for TAVI guidance.Frontiers in cardiovascular medicine · 2026Article
- Clinical evaluation of the Hydra self-expanding THV: 30-day results from the GENESIS-II study.AsiaIntervention · 2025Article
- Long-Term Outcomes of Mild Paravalvular Leak Following Transcatheter Aortic Valve Replacement.Structural heart : the journal of the Heart Team · 2025Article
- Invasive and Echocardiographic Mean Transvalvular Pressure Gradients of Different Transcatheter Aortic Valve Prostheses.Journal of clinical medicine · 2025Article
- Outcomes Beyond 10 Years After Transcatheter Aortic Valve Implantation in High-Risk Patients With Severe Aortic Valve Stenosis.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2025Article
- Management of TAVI Underexpansion with Self-Expanding Valves: A Practical Approach.Journal of cardiovascular development and disease · 2025Review
- Paravalvular Leak After Transcatheter Aortic Valve Implantation: Results From 3600 Patients.The Annals of thoracic surgery · 2025Article
- Management of complications after valvular interventions.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2025Review
- Paravalvular Leak in Transcatheter Aortic Valve Implantation: A Review of Current Challenges and Future Directions.Journal of cardiovascular development and disease · 2025Review
- Clinical Presentation and Percutaneous Treatment of Hemolytic Anemia Associated With Paravalvular Leak After TAVR.JACC. Case reports · 2025Article
- Incidence and Pathology of Aortic Regurgitation.Interventional cardiology (London, England) · 2025Review
- Assessment of paravalvular regurgitation after transcatheter aortic valve replacement using 2D multi-velocity encoding and 4D flow cardiac magnetic resonance.European heart journal. Cardiovascular Imaging · 2024Article
- Paravalvular regurgitation after transcatheter aortic valve replacement: incidence, quantification, and prognostic impact.European heart journal. Imaging methods and practice · 2024Review
- Multicenter comparison of transcatheter aortic valve implantation with the self-expanding ACURATE neo2 versus Evolut PRO transcatheter heart valves.Clinical research in cardiology : official journal of the German Cardiac Society · 2024Article
- Association between three-year mortality after transcatheter aortic valve implantation and paravalvular regurgitation graded by videodensitometry in comparison with visual grading.Clinical research in cardiology : official journal of the German Cardiac Society · 2024Article
- Comparison of the New-Generation Self-Expanding NAVITOR Transcatheter Heart Valve with Its Predecessor, the PORTICO, in Severe Native Aortic Valve Stenosis.Journal of clinical medicine · 2023Article
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
backgroundModerate or worse paravalvular regurgitation (PVR) post transcatheter aortic valve replacement (TAVR) is associated with increased mortality. The mechanisms by which this occurs are not fully understood.
aimsThe aim of this study was to determine the mechanism by which PVR leads to worse outcomes.
methodsA total of 1,974 intermediate-risk patients who received TAVR in the PARTNER 2 trial and registries were grouped by PVR severity. Clinical and echocardiographic outcomes were compared.
resultsOverall 1,176 (60%) patients had none/trace, 680 (34%) had mild, and 118 (6%) had ≥moderate PVR. At two years, ≥moderate PVR patients had increased risks of all-cause (HR 2.33 [1.41-3.85], p-value=0.001) and cardiovascular death (HR 3.30 [1.74-6.28], p-value <0.001), rehospitalisation (HR 2.68 [1.57-4.58], p-value <0.001), and reintervention (HR 14.72 [3.13-69.32], p-value <0.001). Moderate or worse PVR was associated with larger increases in left ventricular (LV) end-diastolic and systolic dimensions and volumes, LV mass indices, and reductions in LV ejection fractions (LVEFs) from 30 days to two years. Mild PVR was not associated with worse outcomes. Adjusting for LV dimensions and LVEF from the one-year echocardiogram, patients with ≥moderate PVR still had an increased risk of all-cause death or rehospitalisation at two years (HR 2.84 [1.25-5.78], p-value=0.009).
conclusionsModerate or worse PVR, but not mild PVR, is associated with an increased risk of all-cause and cardiovascular death, rehospitalisation, and reintervention at two years. Moderate or worse PVR is also associated with adverse LV remodelling, which partially mediates how ≥moderate PVR leads to worse outcomes. These results provide dual insights on the deleterious impact of ≥moderate PVR and the contributing mechanisms of poor clinical outcomes.
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