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Percutaneous paravalvular leak closure: chasing the chameleon
Fabian Nietlispach1, Francesco Maisano2, Paul Sorajja3
1University Heart Center Zurich, Zurich, Switzerland fabian.nietlispach@usz.ch.
Insights
Paravalvular leak (PVL) after valve replacement can cause serious complications. Percutaneous closure offers a less invasive treatment option, improving patient outcomes and prognosis.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- Paravalvular leak (PVL) is a complication following surgical and transcatheter valve replacement.
- PVL can lead to significant adverse events, including hemolysis, heart failure, and increased risk of endocarditis.
Purpose of the Study:
- To highlight the significance of percutaneous closure for paravalvular leaks.
- To emphasize the benefits of percutaneous closure over re-operation.
- To underscore the need for further research and larger case series to refine percutaneous PVL closure techniques.
Main Methods:
- Review of percutaneous closure procedures for paravalvular leaks.
- Analysis of patient outcomes and procedural success rates.
- Discussion of the comparative morbidity of percutaneous closure versus re-operation.
Main Results:
- Percutaneous PVL closure is associated with significantly lower morbidity compared to re-operation.
- This minimally invasive approach can substantially improve patient prognosis.
- The procedure can be technically challenging, necessitating further development.
Conclusions:
- Percutaneous closure is a valuable therapeutic option for paravalvular leaks.
- Further research and larger case series are crucial for optimizing percutaneous PVL closure techniques and improving patient care.
Abstract:
Paravalvular leak (PVL) occurs after both surgical and transcatheter valve replacement/implantation. It can lead to haemolysis, heart failure and may increase the risk of endocarditis. Percutaneous closure has significantly less morbidity than re-operation and is therefore often the therapy of choice. Percutaneous PVL closure can make an important difference for patients and can improve patient prognosis. These procedures can be intricate and larger case series and research is needed to further develop and improve these procedures.
