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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Trans-catheter paravalvular leak closure: a single-centre experience
Richard Tanner1, Saber Hassan1,2, Nicola Ryan1,3
1Department of Cardiology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland.
Irish Journal of Medical Science
|September 14, 2018
Summary
Percutaneous closure of paravalvular leak (PVL) is a safe alternative to surgery, with 86% clinical success. This minimally invasive approach is particularly effective for patients with heart failure (HF).
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- Significant paravalvular leak (PVL) affects 1-3% of patients post-valve replacement.
- Surgical PVL repair has a high 30-day mortality rate of approximately 10%.
- Percutaneous PVL closure is an emerging alternative to surgical intervention.
Purpose of the Study:
- To evaluate the clinical outcomes of percutaneous PVL closure.
- To assess the safety and efficacy of this minimally invasive technique.
- To identify patient subgroups who benefit most from percutaneous PVL closure.
Main Methods:
- Prospective registry for patient and procedural data.
- Retrospective review of medical records for outcomes.
- Analysis of clinical success, complications, and mortality.
Main Results:
- 26 procedures in 21 patients (mean age 68 years).
- 86% overall clinical success, higher in heart failure (HF) patients (100%) vs. hemolysis (HL) (66%).
- 0% 30-day mortality, one stroke (3.8%), 28% mortality at 22-month follow-up.
Conclusions:
- Percutaneous PVL closure is a safe and effective alternative to surgery.
- It is particularly beneficial for patients presenting with heart failure.
- PVL patients represent a high-risk group, benefiting from less invasive options.
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