Transcatheter closure of paraprosthetic valve leaks post surgical valve replacements / 中华心血管病杂志

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the feasibility and efficacy of transcatheter closure of paravalvular leak (PVL) with Chinese-made occluder.</p><p><b>METHODS</b>Five PVL patients were involved in this study, 2 out of the 5 patients underwent aortic mechanical valve replacements, 2 underwent mitral bioprosthetic valve replacements, and the remaining 1 underwent double mechanical valve replacement.Left ventricular end diastolic diameter, left atrial diameter and the systolic pulmonary artery pressure were assessed by echocardiography before and post the procedure.</p><p><b>RESULTS</b>Complete occlusion without residual regurgitation was achieved in 2 patients with aortic PVL, for the 3 patients with mitral PVL, there was only tiny or mild mitral paraprosthetic leak remained post closure procedure. Cardiac perforation and pericardium tamponade occurred in 1 patient with aortic PVL during interventional closure and the patient recovered post emergent pericardiocentesis. Transient severe hemolysis and hemoglobinuria occurred in 3 patients with mitral PVL post closure procedure and they recovered after 1 to 3 weeks conservative therapy. During 3 months follow up, left ventricular end diastolic diameter [(52.2 ± 6.8) mm vs. (61.1 ± 7.2) mm, P < 0.05], the systolic pulmonary artery pressure [(40.0 ± 5.4) mm Hg (1 mm Hg = 0.133 kPa) vs. (57.0 ± 3.6) mm Hg, P < 0.05] and left atrial diameter of mitral PVL patient [(49.0 ± 4.3) mm vs. (56.0 ± 6.3) mm, P < 0.05] were significantly reduced compared to before closure procedure.</p><p><b>CONCLUSION</b>Percutaneous or transapical left ventricular access closure of PVL is feasible, effective and relative safe in selected patients.</p>