Percutaneous paravalvular leak closure

Robert Kumar; Vladimir Jelnin; Chad Kliger; Carlos E Ruiz

doi:10.1016/j.ccl.2013.05.004

Percutaneous paravalvular leak closure

Cardiol Clin. 2013 Aug;31(3):431-40. doi: 10.1016/j.ccl.2013.05.004.

Authors

Robert Kumar¹, Vladimir Jelnin, Chad Kliger, Carlos E Ruiz

Affiliation

¹ Department of Structural and Congenital Heart Disease, Lenox Hill Heart and Vascular Institute, North Shore/LIJ Health System, New York, NY 10021-10075, USA.

PMID: 23931104
DOI: 10.1016/j.ccl.2013.05.004

Abstract

Percutaneous paravalvular leak closure is increasingly being performed as an alternative to reoperation in patients with symptomatic prosthetic paravalvular regurgitation. This article reviews the pathogenesis of paravalvular leaks and percutaneous techniques for closure. Newer multimodality imaging techniques, including 3-dimensional (3D) transesophageal echocardiography and 3D/4D computed tomographic angiography, allow improved preprocedural planning and intraprocedural guidance. Specific techniques can be used for challenging patient anatomy and larger paravalvular leaks. Outcomes from experienced centers show acceptable rates of technical and clinical success, with lower procedural morbidity than reoperation.

Keywords: Congestive heart failure; Hemolytic anemia; Paravalvular regurgitation; Percutaneous closure; Prosthetic valve.

Publication types

Review

MeSH terms

Cardiac Catheterization / methods*
Cardiac Imaging Techniques
Heart Valve Diseases / therapy*
Heart Valve Prosthesis Implantation / methods*
Heart Valve Prosthesis*
Humans
Postoperative Hemorrhage / prevention & control*
Septal Occluder Device