Consistency of transesophageal echocardiography and angiography in
grading (using the Valve Academic Research Consortium 3 criteria) of
perivalvular regurgitation during transcatheter aortic valve replacement
Abstract
The aim of this study was to evaluate the consistency between
transesophageal echocardiography (TEE) and angiography in grading of
paravalvular regurgitation (PVR) during transcatheter aortic valve
replacement (TAVR) according to the Valve Academic Research Consortium 3
(VARC-3) criteria. 31 patients who underwent TEE and angiography during
TAVR were retrospectively included. Circumferential extent of PVR,
regurgitation volume, regurgitation fraction, and the effective
regurgitant orifice area were measured by TEE. Weighted kappa
coefficient was used to analyze the consistency of the two techniques.
PVR was found in 16 of 31 patients. TEE assessed mild PVR in 14 cases
and moderate PVR in 2 cases. Angiography assessed mild PVR in 12 cases
and moderate PVR in 2 cases. The grading of TEE and angiography were the
same in 29 cases, of which 15 were absent, 12 were mild, and 2 were
moderate. The weighted kappa coefficient for both techniques was 0.88 (P
< 0.001). The Kendall’s W coefficient of the circumferential
extent of PVR, regurgitation volume, regurgitation fraction, and the
effective regurgitant orifice area was 0.285 (P<0.005). TEE
and angiography had strong consistency in the grading (using the VARC-3
criteria) of PVR during TAVR. TEE was a potential diagnostic tool for
classifying PVR.