Benign Intravalvular Strut Leak After Placement of the Inspiris Resilia Valve

Abstract

ObjectivesWhat is the incidence of intravalvular leak after aortic valve replacement with the Inspiris Resilia valve? DesignThis is a retrospective chart review. SettingThis study used data from a single, tertiary care academic center. Participants81 patient charts and echo images were reviewed. InterventionsAll patients received an aortic valve replacement using the Inspiris Resilia valve. Pediatric patients or patients receiving an aortic valve conduit were excluded. Measurements and Main ResultsTransesophageal echo images were reviewed independently by two echocardiographers for incidence and severity of intravalvular leak after Inspiris Resilia valve placement. Outpatient follow-up imaging was then compared to intraoperative findings. Valve size and mean gradients were also documented.Of the 81 TEEs that were reviewed, 56 (69.1%) were found to have a strut leak at the time of implantation. Of these 56 patients, 30 were classified as trace regurgitation, 21 as mild and 5 as moderate. Only one case required a return to bypass due to persistent intravalvular leak. Follow up TTE reports were available for 50 of the patients with no persistent leaks. ConclusionsThis pattern of intravalvular leak is unique to the Inspiris Resilia valve and is commonly found in the intraoperative period. While many hypotheses exist for the origin of this leak, the exact mechanism is unclear. Given the high frequency of this post-procedural finding, it is essential that intraoperative echocardiographers be able to distinguish this clinically insignificant leak based on its origin, severity and direction and provide appropriate recommendations to our surgical colleagues.