Repair of Prosthetic Mitral Valve Paravalvular Leak Using an Off-Pump Transapical Approach

Thourani, Vinod H.; Smith, Colleen; Guyton, Robert A.; Block, Peter C.; Liff, David; Willis, Patrick; Arepalli, Chesnal; Howell, Sharon; Boulton, Bryon J.; Stewart, James A.; Babaliaros, Vasilis

doi:10.1016/j.athoracsur.2011.12.035

Cited by 16 publications

(10 citation statements)

References 7 publications

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“…Consistent with other investigators, 12,13 we found the transapical approach to be both practical and feasible, with complete closure achieved in >85% of patients. Unlike the antegrade transseptal approach, which will be constrained by the anatomic location of the defect and the left atrial size, the transapical approach allows access to defects in all anatomic locations and successful device delivery.…”

Section: Discussionsupporting

confidence: 91%

Hybrid approach for transcatheter paravalvular leak closure of mitral prosthesis in high-risk patients through transapical access

Davidavičius

Ručinskas

Drasutiene

et al. 2014

The Journal of Thoracic and Cardiovascular Surgery

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Section: Discussionsupporting

confidence: 91%

Hybrid approach for transcatheter paravalvular leak closure of mitral prosthesis in high-risk patients through transapical access

Davidavičius

Ručinskas

Drasutiene

et al. 2014

The Journal of Thoracic and Cardiovascular Surgery

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“…In our study group of patients, 9 (18%) of the patients had a diagnosis of PVL within 10 days after discharge from the hospital. Reoperation for repair of PVL is associated with higher morbidity and mortality than the original procedure, with in-hospital mortality rates of 13%, 15%, and 37% for the first, second, and third reoperations, respectively (20). Twenty-two percent of patients with PVLs are diagnosed in the first week after MVR, and another 52% are diagnosed within the first postoperative year.…”

Section: Discussionmentioning

confidence: 99%

The relation between location of paravalvular leakage and time to reoperation after mitral valve replacement: an observational study

Yanartaş

Demir²,

Baysal³

et al. 2013

Anadolu Kardiyol Derg

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Objective: A relation between the location of the paravalvular leakage (PVL) and time to reoperation after mitral mechanical valve replacement was investigated. Methods: In an observational retrospective study plan, from 59 patients who underwent reoperation only 47 patients having clinical and echocardiographic follow-up for five years were included into study. Depending on echocardiographic evaluation of location of leak, patients were divided into Group 1 (Leaflet) and Group 2 (Commissural). Demographics, preoperative variables, causes of reoperation, the time period between diagnosis of PVL and reoperation were recorded. Unpaired t test or Mann-Whitney U test were used for comparison of variables between groups. Results: A PVL was diagnosed after a median time of 180 days (range: 1 day-28 years) after the first mitral valve replacement. The median followup period was 5 years (range; 1-16 years). Age, gender, left ventricular ejection function, number and size of leaks did not differ between groups (p>0.05). The time period between diagnosis and reoperation time was longer in Group 1 in comparison to Group 2 (39.0±9.9 vs. 19.5±12.8 months, p=0.002). The 30-day mortality for valve reoperation was 4.3% (2/47). In Group 1, 2 patients (2/21, 9.8%) died whereas, no death was observed in Group 2 (0/26, 0%) (p=0.002). Conclusion:The time period between diagnosis and reoperation was longer in leaflet leak group in comparison to commissural leak group. We suggest echocardiographic evaluation should include location of the paravalvular leakage during follow-up of patients with PVL after mitral valve replacement. (Anadolu Kardiyol Derg 2014; 14: 61-7)

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“…[5] In addition, each reoperation carries an increased risk of a recurrence of the leak. [6,7] The transfemoral approach is an alternative method to surgical repair. This technique avoids a thoracotomy and has been performed with technical success rates ranging from 60-90% in selected patients at highly experienced centers.…”

Section: Discussionmentioning

confidence: 99%

Mitral paravalvular leak closure via minimal invasive transapical approach

İyisoy¹

2014

Turk Gogus Kalp Dama

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Repair of Prosthetic Mitral Valve Paravalvular Leak Using an Off-Pump Transapical Approach

Cited by 16 publications

References 7 publications

Hybrid approach for transcatheter paravalvular leak closure of mitral prosthesis in high-risk patients through transapical access

Hybrid approach for transcatheter paravalvular leak closure of mitral prosthesis in high-risk patients through transapical access

The relation between location of paravalvular leakage and time to reoperation after mitral valve replacement: an observational study

Mitral paravalvular leak closure via minimal invasive transapical approach

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