Percutaneous Closure of Paravalvular Leaks

Hein, Ralph; Lang, Klaus; Wunderlich, Nina; Wilson, Neil; Sievert, Horst

doi:10.1111/j.1540-8183.2006.00174.x

Cited by 25 publications

(27 citation statements)

References 17 publications

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“…In derzeit zur Verfügung stehenden Publikationen reichen die technischen Erfolgsraten interventioneller Verschlüsse einer PVL (definiert als erfolgreiche Implantation des Device mit signifikanter Reduktion des Regurgitationsjets) von 63 bis 95 % [12,[16][17][18][19]. Klinische Erfolgsraten (definiert als Verbesserung der Belastungsdyspnoe um > 1 NYHA-Klasse und/ oder Verminderung der mechanischen Hämolyse durch Reduktion des Insuffizienzjets) werden in 50-86 % der behandelten Patienten angegeben [12,[16][17][18][19].…”

Section: Klinische Resultateunclassified

“…Klinische Erfolgsraten (definiert als Verbesserung der Belastungsdyspnoe um > 1 NYHA-Klasse und/ oder Verminderung der mechanischen Hämolyse durch Reduktion des Insuffizienzjets) werden in 50-86 % der behandelten Patienten angegeben [12,[16][17][18][19]. Der häufigste Grund eines technischen Versagens in den meisten Berichten beruhte auf der Nichtsondierbarkeit der PLV mithilfe eines hydrophilen Drahts [12,19,20].…”

Section: Klinische Resultateunclassified

“…Blutungen und Gefäßverletzungen, wie ein Aneurysma spurium, sind im Bereich des Zugangswegs analog zu anderen kathetergestützten Verfahren in bis zu 2 % der Fäl-le beschrieben. Die Embolisation des Verschlusssystems trat in 0,7-4 % und eine Interaktion des Verschlusssystems mit der Funktion der in aller Regel mechanischen Herzklappenprothese in 3,5 bis 5 % aller Prozeduren auf [3,12,[16][17][18][19][20][23][24][25]. 30-Tage-Raten schwerwiegender, unerwünschter kardio-und zerebrovaskulä-rer Ereignisse (MACCE) werden beim interventionellen PVL-Verschluss mit etwa 8,7 % angegeben [3].…”

Section: Komplikationenunclassified

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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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Section: Klinische Resultateunclassified

Section: Komplikationenunclassified

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Interventionelle Therapieoptionen paravalvulärer Leckagen

Werner¹,

Kilkowski²,

Zahn³

2015

Herz

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“…It develops more commonly in patients with heavy annular calcification and localized infections (2,3). Although majority of paravalvular leaks (PVL) are asymptomatic, clinically significant paravalvular leaks may develop in up to 5% of patients with prosthetic valves (1) which may cause progressive left ventricular dilatation, congestive heart failure and hemolysis.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous effective closure of severe aortic prosthetic paravalvular leak using Amplatzer duct occluder device with the guidance of 3D TEE

Gökoğlan¹,

Demırkol²,

Kurt³

et al. 2012

Anadolu Kardiyol Derg

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“…Paravalvular leaks occur in about 2-3% of patients after surgical valve repair or replacement [29 ]. Symptomatic complications in this patient population include hemolysis and cardiac decompensation.…”

Section: Percutaneous Valve Repair and Replacementmentioning

confidence: 99%