Long-Term Outcomes of Percutaneous Paravalvular Regurgitation Closure After Transcatheter Aortic Valve Replacement

Abstract

Transcatheter closure of PVR after TAVR can be performed with a high procedural success rate; however, the long-term mortality remains high mainly due to noncardiac causes.

Percutaneous Closure of Paravalvular Regurgitation After Transcatheter Aortic Valve Implantation: A Systematic Review

“…7,8,11,13,15 -22 The imaging modality was not described in other cases. 12 the BE and SE valve groups (1.11 ± 0.73 vs 1.31 ± 0.48; P = 0.14).…”

“…There was 1 serious procedural complication of valve embolization. 12 Patient characteristics and outcomes are summarized in Table 2. The vast majority of the deployed closure devices were Amplatzer vascular plugs (II, III or IV; Figure 1).…”

“…Other devices used were the Amplatzer septal occluder and ventricular septal occluder in a total of 5 cases (Figure 2). 11,12 Only 1 case was performed under transthoracic echocardiography plus fluoroscopy guidance 14 ; other cases were performed under fluoroscopy with transesophageal echocardiography (TEE). 7,8,11,13,15 -22 The imaging modality was not described in other cases.…”

“…Indeed, the largest series by Saia et al showed a 1-year all-cause mortality rate of 38.5%, and 45.8% of patients expired during the total follow-up. 12 These rates were numerically higher than 1-year mortality in the first large trial of TAVI, which was the Placement of Aortic Transcatheter (PARTNER) trial (24.2%-30.7%). 39,40 However, most of the deaths reported by Saia et al were noncardiac (8/11, 72.7%), which was different from the PARTNER trial.…”

“…The success rate of PVR closure after surgical valve replacement (both aortic and mitral) varied from 75% to 90% and numerically approximates the success rate of our study. 23 -26 The only serious procedural complication was valve embolization during an attempt to cross the leak, reported by Saia et al 12 Complications of PVR closure after aortic or mitral valve surgery included emergent surgery (2.9%) and closure-device embolization (1.6%). 7,24 -26 The indications for PCC were mainly shortness of breath or symptomatic heart failure.…”