Percutaneous Paravalvular Leak Closure

Kumar, Robert; Jelnin, Vladimir; Kliger, Chad; Ruiz, Carlos E.

doi:10.1016/j.ccl.2013.05.004

Cited by 28 publications

(19 citation statements)

References 19 publications

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“…20 Fusion of different imaging modalities has gained increasing popularity over the last years. 24 Computed tomography (CT)-fluoroscopy fusion imaging represents a new option especially useful in trasapical access. 24 However, to date there is only limited evidence that fusion imaging improves safety and outcomes in these procedures.…”

Section: Imaging In Transcatheter Paravalvularmentioning

confidence: 99%

“…24 Computed tomography (CT)-fluoroscopy fusion imaging represents a new option especially useful in trasapical access. 24 However, to date there is only limited evidence that fusion imaging improves safety and outcomes in these procedures. 25 Transcatheter Paravalvular Leak Closure Techniques PVL closure is usually performed under general anesthesia, with 2D/3D-TEE and fluoroscopic guidance.…”

Section: Imaging In Transcatheter Paravalvularmentioning

confidence: 99%

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Percutaneous Closure of Paravalvular Leaks: A Systematic Review

Cruz-González

Rama-Merchán

Calvert

et al. 2016

J Interven Cardiology

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Paravalvular leak (PVL) is an uncommon yet serious complication associated with the implantation of mechanical or bioprosthetic surgical valves and more recently recognized with transcatheter aortic valves implantation (TAVI). A significant number of patients will present with symptoms of congestive heart failure or haemolytic anaemia due to PVL and need further surgical or percutaneous treatment. Until recently, surgery has been the only available therapy for the treatment of clinically significant PVLs despite the significant morbidity and mortality associated with re-operation. Percutaneous treatment of PVLs has emerged as a safe and less invasive alternative, with low complication rates and high technical and clinical success rates. However, it is a complex procedure, which needs to be performed by an experienced team of interventional cardiologists and echocardiographers. This review discusses the current understanding of PVLs, including the utility of imaging techniques in PVL diagnosis and treatment, and the principles, outcomes and complications of transcatheter therapy of PVLs.

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Section: Imaging In Transcatheter Paravalvularmentioning

confidence: 99%

Section: Imaging In Transcatheter Paravalvularmentioning

confidence: 99%

Percutaneous Closure of Paravalvular Leaks: A Systematic Review

Cruz-González

Rama-Merchán

Calvert

et al. 2016

J Interven Cardiology

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“…Three-dimensional (3D) TEE is the most indicated method to assess in details the position, severity and hemodynamic repercussion. 13 - 14 In addition, 3D TEE contributes to the strategic planning of percutaneous closure or of surgical treatment. 15 - 18 …”

Section: Introductionmentioning

confidence: 99%

Paravalvular Regurgitation: Clinical Outcomes in Surgical and Percutaneous Treatments

Pinheiro¹,

Rezek²,

Costa³

et al. 2016

Arquivos Brasileiros De Cardiologia

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BackgroundParavalvular regurgitation (paravalvular leak) is a serious and rare complication associated with valve replacement surgery. Studies have shown a 3% to 6% incidence of paravalvular regurgitation with hemodynamic repercussion. Few studies have compared surgical and percutaneous approaches for repair.ObjectivesTo compare the surgical and percutaneous approaches for paravalvular regurgitation repair regarding clinical outcomes during hospitalization and one year after the procedure.MethodsThis is a retrospective, descriptive and observational study that included 35 patients with paravalvular leak, requiring repair, and followed up at the Dante Pazzanese Institute of Cardiology between January 2011 and December 2013. Patients were divided into groups according to the established treatment and followed up for 1 year after the procedure.ResultsThe group submitted to percutaneous treatment was considered to be at higher risk for complications because of the older age of patients, higher prevalence of diabetes, greater number of previous valve surgeries and lower mean creatinine clearance value. During hospitalization, both groups had a large number of complications (74.3% of cases), with no statistical difference in the analyzed outcomes. After 1 year, the percutaneous group had a greater number of re-interventions (8.7% vs 20%, p = 0.57) and a higher mortality rate (0% vs. 20%, p = 0.08). A high incidence of residual mitral leak was observed after the percutaneous procedure (8.7% vs. 50%, p = 0.08).ConclusionSurgery is the treatment of choice for paravalvular regurgitation. The percutaneous approach can be an alternative for patients at high surgical risk.

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“…8,[19][20][21] Because patients with surgically corrected PVLs have a limited life expectancy, 22 the transcatheter approach has emerged as a less invasive, feasible alternative. 4,23,24 According to our study, because the percutaneous approach has emerged as a less invasive alternative for those patients with mild-to-moderate paravalvular regurgitation, transcatheter closure might be considered an early first-line treatment to prevent further deterioration and irreversible cardiac and pulmonary damage.…”

Section: Discussionmentioning

confidence: 97%