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Paravalvular leak closure: Still a challenge with unpredictable results
Ana Galrinho1, Luísa M Branco1, António Fiarresga1
1Hospital de Santa Marta, Lisboa, Portugal.
Revista Portuguesa De Cardiologia
|March 2, 2021
Summary
Percutaneous paravalvular leak (PVL) closure is an alternative treatment, but predictors of success are unclear. Clinical improvement and survival depend on reducing regurgitation and improving heart function.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- Paravalvular leak (PVL) is a significant complication following prosthetic valve implantation.
- PVL can lead to heart failure and hemolysis, impacting patient outcomes.
Purpose of the Study:
- To report single-center experience with percutaneous PVL closure.
- To identify predictors of procedural success and clinical outcomes.
Main Methods:
- Retrospective review of 33 percutaneous PVL closures in 26 patients.
- Utilized 3D transesophageal echocardiography (TEE) and fluoroscopy for assessment and guidance.
- Computed tomography angiography was used in select cases for detailed anatomical characterization.
Main Results:
- Successful closure was achieved in 65.4% of patients.
- Clinical improvement (NYHA I-II) was observed in 69% post-procedure.
- Previous hemolysis was the only predictor of procedural success; clinical improvement correlated with PVL reduction.
Conclusions:
- Percutaneous PVL closure is a viable treatment option.
- Predictors for procedural success remain challenging to define.
- Patient survival is linked to the degree of regurgitation reduction and improvement in New York Heart Association functional class.
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