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Transcatheter Closure of Mitral Paravalvular Leak via Multiple Approaches

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 pro...

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Autores principales: Liu, Yang, Xu, Chennian, Ding, Peng, Tang, Jiayou, Jin, Ping, Li, Lanlan, Chen, Min, Meng, Xin, Zhao, Hongliang, Yang, Jian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7943287/
https://www.ncbi.nlm.nih.gov/pubmed/33746639
http://dx.doi.org/10.1155/2021/6630774
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author Liu, Yang
Xu, Chennian
Ding, Peng
Tang, Jiayou
Jin, Ping
Li, Lanlan
Chen, Min
Meng, Xin
Zhao, Hongliang
Yang, Jian
author_facet Liu, Yang
Xu, Chennian
Ding, Peng
Tang, Jiayou
Jin, Ping
Li, Lanlan
Chen, Min
Meng, Xin
Zhao, Hongliang
Yang, Jian
author_sort Liu, Yang
collection PubMed
description 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.
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spelling pubmed-79432872021-03-19 Transcatheter Closure of Mitral Paravalvular Leak via Multiple Approaches Liu, Yang Xu, Chennian Ding, Peng Tang, Jiayou Jin, Ping Li, Lanlan Chen, Min Meng, Xin Zhao, Hongliang Yang, Jian J Interv Cardiol Research Article 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. Hindawi 2021-03-02 /pmc/articles/PMC7943287/ /pubmed/33746639 http://dx.doi.org/10.1155/2021/6630774 Text en Copyright © 2021 Yang Liu et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Liu, Yang
Xu, Chennian
Ding, Peng
Tang, Jiayou
Jin, Ping
Li, Lanlan
Chen, Min
Meng, Xin
Zhao, Hongliang
Yang, Jian
Transcatheter Closure of Mitral Paravalvular Leak via Multiple Approaches
title Transcatheter Closure of Mitral Paravalvular Leak via Multiple Approaches
title_full Transcatheter Closure of Mitral Paravalvular Leak via Multiple Approaches
title_fullStr Transcatheter Closure of Mitral Paravalvular Leak via Multiple Approaches
title_full_unstemmed Transcatheter Closure of Mitral Paravalvular Leak via Multiple Approaches
title_short Transcatheter Closure of Mitral Paravalvular Leak via Multiple Approaches
title_sort transcatheter closure of mitral paravalvular leak via multiple approaches
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7943287/
https://www.ncbi.nlm.nih.gov/pubmed/33746639
http://dx.doi.org/10.1155/2021/6630774
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