Surgical Transapical Approach for Prosthetic Mitral Paravalvular Leak Closure: Early Results

Ünal, Aydın; Şen, Onur; Kadiroğulları, Ersin; Onan, Burak; Yildirim, Aydın; Bakır, İhsan

doi:10.1111/aor.12757

Cited by 7 publications

(8 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…erefore, the transapical puncture procedure could also be safe. However, there is a potential risk of accidentally puncturing the left anterior descending coronary artery [27][28][29]. So, a selective coronary angiogram is necessary to guide the puncture.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter Closure of Mitral Paravalvular Leak via Multiple Approaches

Liu

Ding

et al. 2021

Journal of Interventional Cardiology

View full text Add to dashboard Cite

Objectives. The purpose of this study was to review the experiences with transcatheter closure of mitral PVL after surgical valve replacement. Background. Transcatheter closure of paravalvular leak (PVL) is an intricate alternative to surgical closure. But it represents one of the most intricate procedures in the field of structural heart interventions, especially for patients with mitral PVL. Methods. From January 2015 through January 2019, 35 patients with mitral PVL after valve replacement underwent transcatheter closure. We reviewed the catheter techniques, perioperative characteristics, and prognosis. The median follow-up was 26 (3–48) months. Results. Acute procedural success was achieved in 33/35 (94.3%) patients. Twenty-five patients had single mitral prosthetic valve replacements; 10 had combined aortic and mitral prosthetic valve replacements previously; 28 had mechanical valves; and 7 had bioprosthetic valves. All percutaneous procedures were performed with local anesthesia except for seven transapical cases with general anesthesia. Multiple approaches were used: transfemoral, transapical, and transseptal via an arteriovenous loop. Multiple devices were deployed. There were no hospital deaths. The procedural time was 67–300 (124 ± 62) minutes. Fluoroscopic time was 17–50 (23.6 ± 12.1) minutes. The hospital stay was 5–17 (8.3 ± 3.2) days. Complications included recurrent hemolysis, residual regurgitation, acute renal insufficiency, and anemia. Twenty-seven (77.1%) patients improved by ≥1 New York Heart Association functional class at the 1-year follow-up. Conclusions. Transcatheter mitral PVL closure requires complex catheter techniques. However, this minimally invasive treatment could provide reliable outcomes and shorter hospital stays in selected patients. This trial is registered with NCT02917980.

show abstract

Section: Discussionmentioning

confidence: 99%

Transcatheter Closure of Mitral Paravalvular Leak via Multiple Approaches

Liu

Ding

et al. 2021

Journal of Interventional Cardiology

View full text Add to dashboard Cite

show abstract

“…The high risk of intraoperative mortality ruled out the patient as a surgical candidate. Furthermore, in their study, because the patient suffered clinically insignificant embolic complication and had no vegetation or paravalvular leakage, they did not insist on removing the valve [ 29 , 30 ] . Lejko-Zupanc et al [ 12 ] defend that in selected cases, particularly those with few complications or minor vegetation, clinical treatment should be attempted first.…”

Section: Discussionmentioning

confidence: 99%

Antifungal Efficacy of Amphotericin B in Candida Albicans Endocarditis Therapy: Systematic Review

Bezerra

Silva

Santos-Veloso

et al. 2020

Braz J Cardiovasc Surg

View full text Add to dashboard Cite

Introduction Although it is the most common agent among the fungal causes of endocarditis, Candida albicans endocarditis is rare. Objective To evaluate the efficacy of amphotericin B in the treatment of C. albicans endocarditis beyond a systematic review. Data search Articles in English, Spanish and Portuguese, conducted in the following databases: MEDLINE, LILACS, IBECS and SciELO, in humans and published in the last 25 years. Study selection Observational studies, clinical trials, and case series providing data on the amphotericin B use in patients with a C. albicans endocarditis diagnosis without age limitations. Data synthesis From the initial search (n=79), 25 articles were fully evaluated, of which 19 were excluded for meeting one or more exclusion criteria, remaining five articles (two observational studies and three case series). Patients using amphotericin B demonstrated improvement in survival rates, and its main use was in association with the surgical method as well as with caspofungin association. Conclusion Literature lacks evidence to conclude about efficacy and safety of amphotericin B in the treatment of fungal endocarditis. Randomized clinical trials are necessary to provide better evidence on the subject.

show abstract

“…Recently a new device (Occlutech PLD Occluder, Occlutech, Jena, Germany) for PVL closure has been developed and introduced into clinical practice. To date, only a few studies of mitral PVL treated by the surgical transapical catheter-based approach have been published [ 21 – 23 ].…”

Section: Discussionmentioning

confidence: 99%

Retrospective analysis of single-center early and midterm results of transapical catheter‑based mitral paravalvular leak closure with a purpose-specific device

Zorinas¹,

Janušauskas²,

Davidavičius³

et al. 2018

pwki

View full text Add to dashboard Cite

IntroductionDue to the recent lack of definitions to establish the severity of paravalvular leak (PVL) and endpoints for its treatment, the effectiveness and safety of a new device for PVL closure have not been comprehensively analyzed.AimTo analyze a single center’s experience of mitral PVL closure in a surgical transapical catheter-based fashion with a purpose-specific device.Material and methodsThis is a retrospective cohort study of patients following transapical catheter-based mitral PVL closure with a purpose-specific device. Data were analyzed at baseline, perioperatively, at discharge, at six months and annually after the procedure.ResultsNineteen patients underwent surgical transapical catheter-based mitral PVL closure with the Occlutech PLD Occluder. Mean follow-up time was 20 ±7 (range: 9–33) months. The patients’ mean age was 64 ±7 years, and 11 (58%) were male. Technical, device and individual patient success at follow-up was achieved in 18 (95%), 16 (84%) and 16 (84%) patients respectively. Median intensive therapy unit stay was one day (1–4) and mean hospital stay was 11 ±4 days. A reduction of paravalvular regurgitation to a mild or lesser degree was achieved in 18 (95%) patients. There were no strokes or myocardial infarctions at follow-up. There were no deaths at 30 days after the procedure. One (5%) patient expired due to progression of heart failure 12 months after surgery. None of the patients required immediate conversion to full sternotomy.ConclusionsSurgical transapical catheter-based mitral PVL closure with the Occlutech PLD Occluder is a safe and clinically effective treatment.

show abstract

Surgical Transapical Approach for Prosthetic Mitral Paravalvular Leak Closure: Early Results

Cited by 7 publications

References 16 publications

Transcatheter Closure of Mitral Paravalvular Leak via Multiple Approaches

Transcatheter Closure of Mitral Paravalvular Leak via Multiple Approaches

Antifungal Efficacy of Amphotericin B in Candida Albicans Endocarditis Therapy: Systematic Review

Retrospective analysis of single-center early and midterm results of transapical catheter‑based mitral paravalvular leak closure with a purpose-specific device

Contact Info

Product

Resources

About