Echocardiographic imaging of procedural complications during self-expandable transcatheter aortic valve replacement.

Overview

Transcatheter aortic valve replacement (TAVR) with the use of the self-expandable Revalving system is an accepted alternative to surgical replacement for severe, symptomatic aortic stenosis in high-risk or inoperable patients. Intraprocedural imaging relies on fluoroscopic guidance, with echocardiographic imaging used as a supportive imaging modality. Intraprocedural transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) offer real-time imaging guidance throughout the procedure and may contribute to improving procedural results. Registries suggest that TAVR may be performed in lower-surgical-risk patients with equal outcomes to high-risk patients with ongoing randomized trials comparing these results with surgical outcomes. Understanding the utility of echocardiographic imaging in diagnosing or preventing complications may be particularly important as we move toward these lower-risk patient populations. This imaging compendium is intended to be a comprehensive compilation of intraprocedural complications imaged by intraprocedural echocardiography.