Outcomes and predictors of success and complications for paravalvular leak closure: an analysis of the SpanisH real-wOrld paravalvular LEaks closure (HOLE) registry

Garcı́a, Eulogio; Arzamendi, Dabit; Jimenez-Quevedo, Pilar; Sarnago, Fernando; Martí, Gerard; Sánchez‐Recalde, Ángel; Lasa-Larraya, Garikoit; Sancho, Manuel; Íñiguez, Andrés; Goicolea, J; Roman, Koldobika Garcia-San; Alonso‐Briales, Juan H.; Molina, Eduardo; Calabuig, J; Freixa, Xavier; Berenguer, Alberto; Valdés‐Chávarri, Mariano; Vázquez, Nicolás; Díaz, J.F. Jiménez; Cruz-González, Ignacio

doi:10.4244/eij-d-16-00581

Cited by 53 publications

(38 citation statements)

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“…The safety and efficacy between these techniques has never been clearly evaluated. This explains the large variation in operator preference that currently exist, and the absence of a uniform PVL closure strategy . Furthermore, several Amplatzer devices (St Jude Medical/Abbott Vascular) have been tested off‐label with variable results during PVL closure.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, several Amplatzer devices (St Jude Medical/Abbott Vascular) have been tested off‐label with variable results during PVL closure. In a recent study, describing the largest clinical experience in Spain, suggests that the Amplatzer Vascular Plug III (St Jude Medical/Abbott Vascular) provides the best closure results . This device is currently not approved and available in the US.…”

Section: Discussionmentioning

confidence: 99%

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Retrograde transmitral paravalvular leak closure through an antegrade transseptal approach: A novel technique

Cubeddu

Crespo

Novaro

2018

Cathet Cardio Intervent

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Mitral paravalvular leak (PVL) remains a well-known complication after mitral valve replacement. Since the first report over 25 years ago, several catheter-based PVL closure techniques have been described. Most of these comprise of either an antegrade transseptal approach, or a retrograde transaortic or transapical approach. We herein report a novel percutaneous mitral PVL closure technique that was safely and successfully performed after failed attempt using a conventional antegrade approach.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Retrograde transmitral paravalvular leak closure through an antegrade transseptal approach: A novel technique

Cubeddu

Crespo

Novaro

2018

Cathet Cardio Intervent

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“…Amplatzer Vascular Plugs II and III seem to be the best options due to their remarkable serial results. There have been reports on the use of Amplatzer Vascular Plug III with positive outcomes [ 4 - 6 ] .…”

Section: Discussionmentioning

confidence: 99%

Symptomatic Aortic Paravalvular Leak: Percutaneous Treatment with Amplatzer Vascular Plug III Device as an Alternative to Surgery

Baztarrica¹,

Heredia²,

Arellano³

et al. 2018

Braz J Cardiovasc Surg

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A significant prosthetic paravalvular leak is an uncommon and severe postsurgical complication correlated to the occurrence of congestive heart failure and hemolytic anemia. Percutaneous treatment has become an attractive and effective proposal to relieve symptoms and reduce complications in patients whose high rate of morbidity/mortality precludes a new surgery.This is the case of an 81-year-old patient with a history of biological aortic valve replacement seeking medical help due to heart failure and hemolytic anemia, with a prosthetic paravalvular regurgitation jet and high surgical mortality according to EuroSCORE II.

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“…Although redo surgery has been accepted as a class I recommendation in the guidelines, transcatheter PVL closure seems to be a feasible alternative to surgery in patients with a high surgical risk and suitable anatomic features [ 4 ]. In many registries and metaanalyses, the safety and efficacy of PVL closure has been reported, with a reasonable rate of procedural success and a low rate of major complications [ 5 – 7 ]. Because there are no specific devices for PVL closure and because of the heterogeneity in the size and shape of the defects, variable vascular and septal occluder devices can be used by the operators [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Closure of mitral paravalvular defects without performing an arteriovenous loop: a case series of fourteen patients

Kılıçgedik

Gündüz

Fedakar

et al. 2017

pwki

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IntroductionThe arteriovenous (AV) loop is recommended when further support is needed during paravalvular leak (PVL) closure.AimWe report the feasibility and safety of mitral PVL closure without constructing an AV loop, based on a single-centre experience.Material and methodsFourteen patients with mitral valve replacement (MVR) who had New York Heart Association (NYHA) class III–IV dyspnoea or NYHA class II symptoms with significant haemolytic anaemia caused by severe or moderate-to-severe paravalvular regurgitation and who underwent transcatheter PVL closure (TPVLC) between May 2014 and February 2017 were enrolled.ResultsIn total, 15 PVL procedures and 19 device deployments were performed. The patients had one (n = 10), three (n = 1) or four (n = 1) devices for closure at the time of the procedure; one patient had two devices from two procedures at different times with different access ways. Nineteen devices (10 (66.6%) via transseptal access; 4 (26.6%), transapical access; and 1 (6.6%), retrograde access) were deployed successfully without making an AV loop.ConclusionsThe TPVLC is a less invasive and effective alternative to surgery in symptomatic patients with significant PVLs and high operational risks. The success rates are satisfactory, with improving techniques and devices. Procedural success without using an AV loop can be achieved with reduced costs, fluoroscopic times and complications.

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Outcomes and predictors of success and complications for paravalvular leak closure: an analysis of the SpanisH real-wOrld paravalvular LEaks closure (HOLE) registry

Abstract: Percutaneous closure of PVL can be performed with a reasonable rate of procedural success and a low rate of major complications. The type of device used, the accumulated experience and the leak size are predictors of procedural success.

Cited by 53 publications

References 0 publications

Retrograde transmitral paravalvular leak closure through an antegrade transseptal approach: A novel technique

Retrograde transmitral paravalvular leak closure through an antegrade transseptal approach: A novel technique

Symptomatic Aortic Paravalvular Leak: Percutaneous Treatment with Amplatzer Vascular Plug III Device as an Alternative to Surgery

Closure of mitral paravalvular defects without performing an arteriovenous loop: a case series of fourteen patients

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