Transcatheter closure of paravalvular leaks: state of the art

Cruz-González, Ignacio; Rama-Merchán, Juan Carlos; Rodríguez-Collado, Javier; Martín‐Moreiras, Javier; Diego-Nieto, Alejandro; Barreiro-Pérez, Manuel; Sánchez, Pedro L.

doi:10.1007/s12471-016-0918-3

Cited by 47 publications

(55 citation statements)

References 31 publications

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“…Additionally, the sheaths and device delivery catheter sizes are smaller than those of ADOs (4–7 Fr) [ 16 ], which facilitates the passage of low-profile catheters from the defect without using an AV loop. The feasibility and safety of using AVP III devices have been reported in the literature [ 2 , 16 – 18 ]. In our case series, we mostly used AVP III devices, and 16 devices were advanced through 6-Fr or 7-Fr delivery catheters and deployed successfully.…”

Section: Discussionmentioning

confidence: 99%

“…In our study, the success rate was satisfactory (86%). In the literature, the technical and clinical success rates ranged from 77% to 86% and 67% to 77%, respectively, and the complication rates were low [ 2 ]. In addition to other studies and registries, our series has shown that TPVLC is a safe and feasible technique and can be used without constructing an AV loop.…”

Section: Discussionmentioning

confidence: 99%

“…mitral valve replacement – MVR) and may be seen in 2–12% of patients after MVR [ 1 ]. Most PVLs are clinically silent, but 1–5% of patients become symptomatic because of heart failure, haemolysis or both and require re-operation [ 2 , 3 ]. Although redo surgery has been accepted as a class I recommendation in the guidelines, transcatheter PVL closure seems to be a feasible alternative to surgery in patients with a high surgical risk and suitable anatomic features [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Closure of mitral paravalvular defects without performing an arteriovenous loop: a case series of fourteen patients

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Fedakar

et al. 2017

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IntroductionThe arteriovenous (AV) loop is recommended when further support is needed during paravalvular leak (PVL) closure.AimWe report the feasibility and safety of mitral PVL closure without constructing an AV loop, based on a single-centre experience.Material and methodsFourteen patients with mitral valve replacement (MVR) who had New York Heart Association (NYHA) class III–IV dyspnoea or NYHA class II symptoms with significant haemolytic anaemia caused by severe or moderate-to-severe paravalvular regurgitation and who underwent transcatheter PVL closure (TPVLC) between May 2014 and February 2017 were enrolled.ResultsIn total, 15 PVL procedures and 19 device deployments were performed. The patients had one (n = 10), three (n = 1) or four (n = 1) devices for closure at the time of the procedure; one patient had two devices from two procedures at different times with different access ways. Nineteen devices (10 (66.6%) via transseptal access; 4 (26.6%), transapical access; and 1 (6.6%), retrograde access) were deployed successfully without making an AV loop.ConclusionsThe TPVLC is a less invasive and effective alternative to surgery in symptomatic patients with significant PVLs and high operational risks. The success rates are satisfactory, with improving techniques and devices. Procedural success without using an AV loop can be achieved with reduced costs, fluoroscopic times and complications.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Closure of mitral paravalvular defects without performing an arteriovenous loop: a case series of fourteen patients

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Fedakar

et al. 2017

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“…Most patients with a small PVL remain asymptomatic or present with mild hemolytic anemia and a benign course. Large PVLs are seen in less than 1% of surgeries and can result in heart failure, severe hemolytic anemia, or endocarditis (54,56,57).…”

Section: Structural Abnormalitiesmentioning

confidence: 99%

Multimodality Imaging of Complications of Cardiac Valve Surgeries

Rajiah¹,

Moore²,

Saboo³

et al. 2019

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Replacement with a prosthetic heart valve (PHV) remains the definitive surgical procedure for management of severe cardiac valve disease. PHV dysfunction is uncommon but can be a life-threatening condition. The broad hemodynamic and pathophysiologic manifestations of PHV dysfunction are stenosis, regurgitation, and a stuck leaflet. Specific structural abnormalities that cause PHV dysfunction include prosthetic valve-patient mismatch, structural failure, valve calcification, dehiscence, paravalvular leak, infective endocarditis, abscess, pseudoaneurysm, abnormal connections, thrombus, hypoattenuating leaflet thickening, and pannus. Multiple imaging modalities are available for evaluating a PHV and its dysfunction. Transthoracic echocardiography is often the first-line imaging modality, with additional modalities such as transesophageal echocardiography, CT, MRI, cine fluoroscopy, and nuclear medicine used for further characterization and establishing a specific cause. The authors review PHVs and the role of imaging modalities in evaluation of PHV dysfunction and illustrate the imaging appearances of different complications.

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“…However, with 3D TEE, what used to be serious invasive procedures with significant morbidity and mortality rates are now noninvasive and routine with outcomes comparable to their invasive counterparts. 4,5 As percutaneous procedures quickly become the procedure of choice for many patients, it subsequently has become integral that cardiac anesthesiologists master the techniques associated with 3D TEE.…”

mentioning

confidence: 99%