{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T15:21:05Z","timestamp":1769268065000,"version":"3.49.0"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,12,7]],"date-time":"2022-12-07T00:00:00Z","timestamp":1670371200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Paravalvular regurgitation (PVR) may be missed intraoperatively with transthoracic echocardiography (TTE) guided minimalist TAVR. We sought to determine the incidence and echocardiographic distribution of PVR missed on intra\u2010op TTE, but detected on predischarge TTE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From July 2015 to 2020, 475 patients with symptomatic severe native aortic stenosis underwent TTE\u2010guided minimalist TAVR. Missed PVR was defined as predischarge PVR that was \u22651 grade higher than the corresponding intra\u2010op PVR severity. PVR was classified as anterior or posterior on the four standard TTE views; parasternal short\u2010axis (PSAX), parasternal long\u2010axis (PLAX), apical 3\u2010chamber (A3C), and 5\u2010chamber (A5C). Location\u2010specific risk of missed PVR was then determined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mild or greater PVR was seen in 55 (11.5%) cases intra\u2010op and 91 (19.1%) at predischarge, with no severe PVR. Among the 91 patients with \u2265mild predischarge PVR, missed PVR was present in 42 (46.2%). Compared to the corresponding anterior jets, missed PVR rate was significantly higher for posterior jets in PLAX (62.5% vs. 25.0%, <jats:italic>p<\/jats:italic>\u2009=\u20090.005), A5C (56.9% vs. 25.0%, <jats:italic>p<\/jats:italic>\u2009=\u20090.009), PSAX (66.7% vs. 24.3%, 0.001), but not A3C (58.5% vs. 40.0%, <jats:italic>p<\/jats:italic>\u2009=\u20090.28).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Intraoperative TTE\u2010guided minimalist TAVR either misses nearly half of \u2265mild PVR or underestimates PVR by \u22651 grade when compared to predischarge TTE. Posterior PVR jets are more likely to be missed. Transesophageal echo guidance may help minimize missing PVR. Further studies are warranted.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30512","type":"journal-article","created":{"date-parts":[[2022,12,7]],"date-time":"2022-12-07T17:03:19Z","timestamp":1670432599000},"page":"180-186","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Minimalist transcatheter aortic valve replacement misses paravalvular regurgitation:\u00a0Incidence and echocardiographic distribution of missed paravalvular regurgitation"],"prefix":"10.1002","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9426-3618","authenticated-orcid":false,"given":"Syed","family":"Zaid","sequence":"first","affiliation":[{"name":"Division of Cardiology Houston Methodist DeBakey Heart and Vascular Center Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7932-9348","authenticated-orcid":false,"given":"Ahmed Abu","family":"Haniyeh","sequence":"additional","affiliation":[{"name":"Division of Cardiology Westchester Medical Center Valhalla New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6757-8841","authenticated-orcid":false,"given":"Akiva","family":"Rosenzveig","sequence":"additional","affiliation":[{"name":"Division of Cardiology Westchester Medical Center Valhalla New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaqib","family":"Malik","sequence":"additional","affiliation":[{"name":"Division of Cardiology Westchester Medical Center Valhalla New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua B.","family":"Goldberg","sequence":"additional","affiliation":[{"name":"Section of Cardiothoracic Surgery Westchester Medical Center Valhalla New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cenap","family":"Undemir","sequence":"additional","affiliation":[{"name":"Section of Cardiothoracic Surgery Westchester Medical Center Valhalla New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Spevack","sequence":"additional","affiliation":[{"name":"Division of Cardiology Westchester Medical Center Valhalla New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven L.","family":"Lansman","sequence":"additional","affiliation":[{"name":"Section of Cardiothoracic Surgery Westchester Medical Center Valhalla New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gilbert H. L.","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Mount Sinai Health System New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hasan","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Division of Cardiology Westchester Medical Center Valhalla New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,12,7]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1200384"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-012-0434-4"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2014.04.005"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2017.03.010"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2017.02.002"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs255"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2015.01.008"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2015.01.002"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.142000"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu384"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.08.050"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.01.047"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1514616"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1114705"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.002677"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1814052"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2014.03.007"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.12.015"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.11.045"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2010.217158"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2011.01.014"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.05.059"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.11.055"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.30512","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccd.30512","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.30512","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T20:57:13Z","timestamp":1692478633000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.30512"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,7]]},"references-count":23,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,1]]}},"alternative-id":["10.1002\/ccd.30512"],"URL":"https:\/\/doi.org\/10.1002\/ccd.30512","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"value":"1522-1946","type":"print"},{"value":"1522-726X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,7]]},"assertion":[{"value":"2022-07-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-12-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}