Percutaneous Treatment of Mitral Valve Periprosthetic Leakage. An Alternative to High-Risk Surgery?

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/s1885-5857(09)71671-8

Cited by 17 publications

(5 citation statements)

References 10 publications

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“…Reproducibility remains a major concern: Technical success rates range from 60% to 90% in different series. 10,[12][13][14][15][16][17] Transapical access represents an attractive alternative solution for transcatheter mitral PVL closure, ensuring by definition coaxiality to the mitral plane and direct engagement to the leak. 18 We recently reported satisfactory acute results of a small series of 17 patients who underwent mitral PVL closure through the transapical route.…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of paravalvular leak: Long-term results in a single-center experience (up to 14 years)

Taramasso

Maisano²,

Denti

et al. 2015

The Journal of Thoracic and Cardiovascular Surgery

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Section: Discussionmentioning

confidence: 99%

Surgical treatment of paravalvular leak: Long-term results in a single-center experience (up to 14 years)

Taramasso

Maisano²,

Denti

et al. 2015

The Journal of Thoracic and Cardiovascular Surgery

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“…A significant improvement of the functional status of the patients after the procedure was observed. 46 Cort es et al 47 Garc ıa et al 48 Nietlispach et al 49 Ruiz et al 10 Sorajja et al 12 Swaans et al 50 Boccuzzi et al 51 Noble et al 42 Smolka et al 52 Smolka et al 53 Cruz-Gonzalez et al 38 S anchez-Recalde et al 39 Number of patients…”

Section: Paravalvular Leak After Transcatheter Aortic Valve Replacementmentioning

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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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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“…Moreover, surgery may not be successful since the original anatomical problems persist. Because of these issues, there is tremendous interest in minimally invasive percutaneous techniques that may allow successful treatment of paravalvular regurgitation without another sternotomy (2)(3)(4)(5)(6)(7)(8)(9)(10)(11).…”

Section: Principles Of Percutaneous Paravalvular Leak Closurementioning

confidence: 99%

Principles of Percutaneous Paravalvular Leak Closure

Rihal

Sorajja

Booker

et al. 2012

JACC: Cardiovascular Interventions

159

106

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Paravalvular regurgitation affects 5% to 17% of all surgically implanted prosthetic heart valves. Patients who have paravalvular regurgitation can be asymptomatic or present with hemolysis or heart failure, or both. Reoperation is associated with increased morbidity and is not always successful because of underlying tissue friability, inflammation, or calcification. Comprehensive echocardiographic imaging with transthoracic and real-time 3-dimensional transesophageal echocardiography is key for characterizing the defect location, size, and shape. For paramitral defects, an antegrade transseptal approach can usually be guided by biplane fluoroscopy, and real-time 3-dimensional transesophageal echocardiography can usually be performed successfully. Alternative approaches to paramitral defects include retrograde transaortic cannulation or transapical access and retrograde cannulation. For oblong or crescentic defects, the simultaneous or sequential deployment of 2 smaller devices, as opposed to 1 large device, results in a higher degree of procedural success and safety because the risk of impingement on the prosthetic leaflets is minimized. Most para-aortic defects can be approached in a retrograde manner and closed with a single device. With careful anatomical assessment, procedural planning, and procedural execution, successful closure rates of 90% or more should be attainable with a low risk of device impingement on the prosthetic valve or embolization.

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Percutaneous Treatment of Mitral Valve Periprosthetic Leakage. An Alternative to High-Risk Surgery?

Cited by 17 publications

References 10 publications

Surgical treatment of paravalvular leak: Long-term results in a single-center experience (up to 14 years)

Surgical treatment of paravalvular leak: Long-term results in a single-center experience (up to 14 years)

Percutaneous Closure of Paravalvular Leaks: A Systematic Review

Principles of Percutaneous Paravalvular Leak Closure

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