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Percutaneous mitral and aortic paravalvular leak repair: indications, current application, and future directions


Binder, Ronald K; Webb, John G (2013). Percutaneous mitral and aortic paravalvular leak repair: indications, current application, and future directions. Current Cardiology Reports, 15:342.

Abstract

Paravalvular regurgitation (PVR) is a symptomatic or asymptomatic complication after surgical valve replacement. It may be related to calcification, infection or tissue friability and occurs in 5 % to 17 % of surgical implanted heart valves. Reoperation is associated with a higher morbidity and mortality than the index procedure. Percutaneous closure of PVR can be an effective and lower risk alternative to reoperation. However, feasibility for percutaneous closure has to be assessed by defining the shape, size and location of the defect. Echocardiography with three-dimensional defect reconstruction is a cornerstone for guiding percutaneous PVR closure. Access for aortic PVR is usually retrograde via the femoral artery and access to mitral PVR either retrograde from the aorta, transvenous-transseptal or transapical. Meticulous planning and prudent procedural execution by experienced operators ensuring no impingement of the prosthetic leaflets leads to a high success rate of percutaneous PVR repair.

Abstract

Paravalvular regurgitation (PVR) is a symptomatic or asymptomatic complication after surgical valve replacement. It may be related to calcification, infection or tissue friability and occurs in 5 % to 17 % of surgical implanted heart valves. Reoperation is associated with a higher morbidity and mortality than the index procedure. Percutaneous closure of PVR can be an effective and lower risk alternative to reoperation. However, feasibility for percutaneous closure has to be assessed by defining the shape, size and location of the defect. Echocardiography with three-dimensional defect reconstruction is a cornerstone for guiding percutaneous PVR closure. Access for aortic PVR is usually retrograde via the femoral artery and access to mitral PVR either retrograde from the aorta, transvenous-transseptal or transapical. Meticulous planning and prudent procedural execution by experienced operators ensuring no impingement of the prosthetic leaflets leads to a high success rate of percutaneous PVR repair.

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17 citations in Web of Science®
13 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2013
Deposited On:13 Feb 2014 15:05
Last Modified:05 Apr 2016 17:39
Publisher:Springer
ISSN:1523-3782
Publisher DOI:https://doi.org/10.1007/s11886-012-0342-2
PubMed ID:23338724

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