Cierre percutáneo de las dehiscencias periprotésicas mitrales. ¿La alternativa a una cirugía de alto riesgo?

Fernández, Rafael García-Borbolla; Jaldón, Manuel Sancho; Pérez, Germán Calle; Menchero, Antonio Enrique Gómez; Rueda, Ricardo de Zayas; Granado, Roque Arana; Fuertes, Ernesto Marante; Laínez, Pedro Cabeza

doi:10.1016/s0300-8932(09)70901-7

Cited by 33 publications

(2 citation statements)

References 10 publications

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“…La dehiscencia periprotésica es una complicación poco frecuente, pero con significativas consecuencias clínicas, principalmente insuficiencia cardíaca y anemia hemolítica. (1,2,3) El cierre percutáneo de dehiscencias periprotésicas es un procedimiento seguro, pero técnicamente reservado para pacientes de alto riesgo quirúrgico. Tiene aceptables resultados a corto plazo, pero en muchos casos se necesitarán nuevas intervenciones (1,5) .…”

Section: Conclusiónunclassified

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Cierre percutáneo de dehiscencias (leaks) periprotésicas

Kudrle

Sorensen

Álvarez

et al. 2016

Rev Ecocar Pract (RETIC)

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Se presenta el caso de una paciente añosa, con enfermedad mitroaórtica y endocarditis mural y mitral que requirió reemplazo mitroaórtico con prótesis biológicas, evolucionando con insuficiencia cardíaca de difícil manejo secundaria a dehiscencias paravalvulares de prótesis mitral. La ecocardiografía transesofágica tridimensional (ETE 3D) permitió caracterizar adecuadamente los defectos y guiar el cierre de los mismos en esta paciente de alto riesgo quirúrgico.

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Section: Conclusiónunclassified

“…La ecocardiografía tridimensional permite una mejor caracterización del defecto y facilita la guía del procedimiento, disminuyendo los tiempos de realización del mismo. (1,3,4,5)…”

Section: Conclusiónunclassified

Cierre percutáneo de dehiscencias (leaks) periprotésicas

Kudrle

Sorensen

Álvarez

et al. 2016

Rev Ecocar Pract (RETIC)

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Percutaneous Closure of Paravalvular Leaks

Faletra

Perk

Pandian

et al. 2013

Real-Time 3D Interventional Echocardiography

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Interventionelle Therapieoptionen paravalvulärer Leckagen

Werner¹,

Kilkowski²,

Zahn³

2015

Herz

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Paravalvular leak (PVL) is a relatively rare, but serious complication occurring in up to 10% of patients after prosthetic aortic valve replacement and in up to 17% of patients after prosthetic mitral valve replacement. Up to 5% of patients will present with symptoms of congestive heart failure or mechanical haemolytic anaemia due to PVL and need further surgical or interventional treatment. Surgical repair is often technically challenging and carries a high mortality and morbidity risk. Catheter-based closure of PVL has emerged as an alternative approach especially for patients with relevant comorbidities at high surgical risk. Interventional closure of PVL is a complex procedure, which needs to be performed by an experienced team of interventional cardiologist, echocardiographer and anesthesiologist. To date available clinical results are promising showing low complication rates and high technical or clinical success rates of catheter-based closure of PVL (60-90%). Compared to surgical closure of PVL lower mortality rates (30-days mortality rate: 4,6%) have been documented in patients treated by catheter-based closure of PVL in clinical practice. Therefore interventional closure seems to be a promising option, which need to be discussed with every symptomatic patient suffering from PVL prior to therapeutical decision making. To date only sparse clinical data is available regarding indication and clinical outcome of patients undergoing catheter-based PVL in clinical practice. Therefore interventional closure of PVL should be limited to experienced interventional cardiologist at present. All patients treated should further be enrolled into a clinical registry to evaluate the safety and efficacy of catheter-based closure of PVL in clinical practice.

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Cierre percutáneo de las dehiscencias periprotésicas mitrales. ¿La alternativa a una cirugía de alto riesgo?

Cited by 33 publications

References 10 publications

Cierre percutáneo de dehiscencias (leaks) periprotésicas

Cierre percutáneo de dehiscencias (leaks) periprotésicas

Percutaneous Closure of Paravalvular Leaks

Interventionelle Therapieoptionen paravalvulärer Leckagen

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