Percutaneous management of paravalvular leaks

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Joel P Giblett1,2, Bushra S Rana1, Leonard M Shapiro1

  • 1Department of Cardiology, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK.

Nature Reviews. Cardiology
|January 20, 2019
PubMed

Insights

Paravalvular leak (PVL) closure is a common complication after valve surgery. Percutaneous closure is now the primary treatment, offering improved outcomes and reduced complications.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Paravalvular leak (PVL) occurs in 5-17% of patients post-prosthetic valve implantation.
  • While often benign, PVLs can lead to significant morbidity and mortality.
  • Percutaneous closure is the current first-line treatment for PVL.

Purpose of the Study:

  • To review the frequency and clinical consequences of PVL closure.
  • To discuss the role of cardiac imaging in PVL assessment and management.
  • To summarize clinical evidence for percutaneous PVL closure.

Main Methods:

  • Review of literature on paravalvular leak (PVL) closure.
  • Discussion of cardiac imaging techniques (echocardiography, CT) for PVL assessment.
  • Analysis of national registries and comparative data for percutaneous vs. surgical closure.

Main Results:

  • Percutaneous closure is effective and becoming the standard of care for PVL.
  • Cardiac imaging plays a crucial role in guiding PVL closure procedures.
  • Evidence from registries supports the efficacy of percutaneous closure compared to surgical options.

Conclusions:

  • Percutaneous closure is the preferred treatment for paravalvular leaks.
  • Comprehensive imaging is essential for successful PVL management.
  • Clinical data support the safety and efficacy of percutaneous PVL closure.

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