{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T17:25:11Z","timestamp":1767893111087,"version":"3.49.0"},"reference-count":13,"publisher":"PAGEPress Publications","license":[{"start":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T00:00:00Z","timestamp":1618963200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Monaldi Arch Chest Dis"],"abstract":"<jats:p>Paravalvular regurgitation (PVR) is a serious complication after surgical valve replacement. Echocardiography is the gold standard technique to assess the severity of PVR with an integrated approach.A 48-year-old male underwent aortic valve replacement due to infective endocarditis (IE). During in-hospital cardiac rehabilitation after a redo surgery for a new IE three years later, an echo-free anterior space around the valve with several PVRs through transthoracic echocardiography (TTE) was identified. On transesophageal echocardiography (TOE) a double PVR (anterior and posterior) with abscessual cavity was detected. The patient\u2019s conditions worsened within six months with hemodynamic instability: a massive PVR due to a large abscess cavity next to the right cusp was confirmed by TTE and TOE and a third surgery was carried out. On the third admission at our Rehabilitation Unit the echo features were normal. Patient did not report any cardiovascular symptoms at 1 year follow-up.<\/jats:p>","DOI":"10.4081\/monaldi.2021.1765","type":"journal-article","created":{"date-parts":[[2021,4,22]],"date-time":"2021-04-22T04:26:03Z","timestamp":1619065563000},"source":"Crossref","is-referenced-by-count":1,"title":["Echocardiographic evaluation of paravalvular aortic regurgitation of a patient with recurrent aortic valve replacements"],"prefix":"10.4081","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0789-0080","authenticated-orcid":false,"given":"Lorenzo","family":"Cannata","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1958-1349","authenticated-orcid":false,"given":"Camilla","family":"Zocco Ramazzo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2549","published-online":{"date-parts":[[2021,4,21]]},"reference":[{"key":"3829","doi-asserted-by":"crossref","unstructured":"Safi AM, Kwan T. Paravalvular regurgitation: a rare complication following valve replacement surgery. Angiology 2000;51:479-87.","DOI":"10.1177\/000331970005100605"},{"key":"3830","doi-asserted-by":"crossref","unstructured":"Zoghbi WA, Asch FM, Bruce C, et al. Guidelines for the Evaluation of Valvular Regurgitation After Percutaneous Valve Repair or Replacement A Report from the American Society of Echocardiography Developed in Collaboration with the Society for Cardiovascular Angiography and Interventions, Japanese Society of Echocardiography, and Society for Cardiovascular Magnetic Resonance. Erratum in: [No authors listed] J Am Soc Echocardiogr 2019;32:914-7. J Am Soc Echocardiog 2019;32:431-75.","DOI":"10.1016\/j.echo.2019.01.003"},{"key":"3831","doi-asserted-by":"crossref","unstructured":"Habib G, Lancellotti P, Antunes MJ, et al. 2015 ESC Guidelines for the management of infective endocarditis - The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). Eur Heart J 2015;36:3075-23.","DOI":"10.1093\/eurheartj\/ehv319"},{"key":"3832","doi-asserted-by":"crossref","unstructured":"Summers MR, Leon MB, Smith CR, et al. Prosthetic Valve Endocarditis After TAVR and SAVR - Insights From the PARTNER Trials. Circulation 2019;140:1984\u201394.","DOI":"10.1161\/CIRCULATIONAHA.119.041399"},{"key":"3833","doi-asserted-by":"crossref","unstructured":"Ruiz CR, Hahn RT, Alain Berrebi A, et al. Clinical trial principles and endpoint definitions for paravalvular leaks in surgical prosthesis. An expert statement. J Am Coll Cardiol 2017;69:2067-87.","DOI":"10.1016\/j.jacc.2017.02.038"},{"key":"3834","doi-asserted-by":"crossref","unstructured":"Kyt\u04e7 V, Ahtela E, J Sipil\u04d3 J, et al. Mechanical versus biological valve prosthesis for surgical aortic valve replacement in patients with infective endocarditis. Interact Cardiovasc Thoracic Surg 2019;29:386-92.","DOI":"10.1093\/icvts\/ivz122"},{"key":"3835","doi-asserted-by":"crossref","unstructured":"Pinheiro CP, Rezek D, Costa EP, et al. Paravalvular regurgitation: Clinical outcomes in surgical and percutaneous treatments. Arq Bras Cardiol 2016;107:55-62.","DOI":"10.5935\/abc.20160086"},{"key":"3836","doi-asserted-by":"crossref","unstructured":"Del Val Mart\u00ecn D, Zamorano G\u00f2mez JL. The role of imaging in paravalvular leak assessment. In: G Smolka, W Wojakowski, M Tendera, Editors. Transcatheter paravalvular leak closure. Springer, Singapore; 2017. p. 13-42.","DOI":"10.1007\/978-981-10-5400-6_2"},{"key":"3837","doi-asserted-by":"crossref","unstructured":"Geleijnse ML, Di Martino LFM, Vletter WB, et al. Limitations and difficulties of echocardiographic short-axis assessment of paravalvular leakage after corevalve transcatheter aortic valve implantation. J Cardiovascular Ultrasound 2016;14:37.","DOI":"10.1186\/s12947-016-0080-5"},{"key":"3838","doi-asserted-by":"crossref","unstructured":"Hryniewiecki T, Zatorska K, Abramczuk E, et al. The usefulness of cardiac CT in the diagnosis of perivalvular complications in patients with infective endocarditis. Eur Radiology 2019;29:4368\u201376.","DOI":"10.1007\/s00330-018-5965-2"},{"key":"3839","doi-asserted-by":"crossref","unstructured":"Eleid MF, Cabalka AK, Malouf JF, et al. Techniques and outcomes for the treatment of paravalvular leak. Circ Cardiovasc Interv 2015;8:e001945.","DOI":"10.1161\/CIRCINTERVENTIONS.115.001945"},{"key":"3840","unstructured":"Salaun E, Jacquier A, Theron A, et al. Value of CMR in quantification of paravalvular aortic regurgitation after TAVI. Eur Heart J Cardiovasc Imaging 2016;17:41-50."},{"key":"3841","doi-asserted-by":"crossref","unstructured":"Ghersin E, Martinez CA, Singh V, et al. ECG-Gated MDCT after aortic and mitral valve surgery. 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