Balloon-assisted paravalvular leakage crossing for transcatheter closure: a pilot study

Area of Science:

• Cardiology
• Interventional Cardiology
• Medical Devices

Background:

• Transcatheter closure is a standard treatment for paravalvular leaks (PVL).
• Anatomical complexity and lack of specialized equipment often make PVL crossing difficult.
• Existing methods for PVL crossing can be challenging and carry risks.

Purpose of the Study:

• To assess the safety and efficacy of using an angioplasty balloon to facilitate PVL passage.
• To evaluate a novel technique for improving transcatheter PVL closure success rates.
• To explore alternative methods for navigating complex PVL anatomies.

Main Methods:

• A registry of 12 cases involving predilatation of the PVL tract using a coronary balloon was described.
• This technique was employed after initial attempts to pass the sheath through the PVL failed.
• The primary outcome was successful occluder implantation after balloon predilatation.

Main Results:

• The procedure was successful in all 12 cases, enabling final occluder implantation.
• No adverse events were directly attributed to the use of the coronary balloon predilatation technique.
• The technique proved effective in overcoming challenges associated with PVL tract navigation.

Conclusions:

• Predilatation of the PVL channel with small coronary balloons is a viable alternative method for transcatheter PVL closure.
• This technique demonstrates potential for improving procedural success in complex PVL anatomies.
• Further research and technique refinement are warranted based on these preliminary findings.