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Kalogeras K, Ntalekou K, Aggeli K, Moldovan C, Katsianos E, Kalantzis C, Bei E, Mourmouris C, Spargias K, Chrissoheris M, Dardas P, Aznaouridis K, Tzifa A, Theofilogiannakos E, Siasos G, Tousoulis D, Vavuranakis M. Transcatheter closure of paravalvular leak: Multicenter experience and follow-up. Hellenic J Cardiol 2021; 62:416-422. [PMID: 33617960 DOI: 10.1016/j.hjc.2021.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 12/22/2020] [Accepted: 02/12/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Paravalvular leak (PVL) is a common complication following valve replacement, which leads to heart failure and hemolysis. Transcatheter PVL closure has emerged as a reliable alternative with promising results. We quote the combined three-center experience of PVL patients treated percutaneously. METHODS Consecutive patients treated percutaneously for PVL were retrospectively studied. Procedural characteristics, inhospital, and long-term clinical outcomes were assessed. Technical (successful deployment) and clinical (NYHA and/or hemolysis improvement) success were evaluated. RESULTS In total, 39 patients treated for PVL in either the aortic (12 patients) or the mitral (27 patients) position were studied. Amplatzer Vascular Plug III was the most commonly used device among the 45 devices totally implanted. Postprocedurally, the rates of at least moderate PVL (87.5% preprocedurally vs 10.5% at discharge) and functional status (mean NYHA class 2.8 ± 0.7 on admission vs 1.5 ± 0.8 at follow-up) were statistically significantly improved. Total population technical success rate was 89.7%, being comparable between patients treated for mitral or aortic valve PVLs (92.6% vs 83.3%, respectively). Clinical success was achieved in 82.1% of patient cohort without statistical difference among those with isolated aortic or mitral PVL or among those with PVL closure an indication of heart failure or hemolysis. During a mean follow-up of 33.5 months, five patients died, including one periprocedural death. CONCLUSIONS This multicenter recorded experience confirms that percutaneous PVL closure can be performed with high technical and clinical success rates and limited complications that lead to significant PVL reduction and functional status improvement.
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Affiliation(s)
- Konstantinos Kalogeras
- 1(st) Department of Cardiology, University of Athens, 'Hippokration' Hospital, Athens, Greece; 3(rd) Department of Cardiology, University of Athens, 'Sotiria' Hospital, Athens, Greece.
| | - Konstantina Ntalekou
- 1(st) Department of Cardiology, University of Athens, 'Hippokration' Hospital, Athens, Greece
| | - Konstantina Aggeli
- 1(st) Department of Cardiology, University of Athens, 'Hippokration' Hospital, Athens, Greece
| | - Carmen Moldovan
- 1(st) Department of Cardiology, University of Athens, 'Hippokration' Hospital, Athens, Greece
| | - Efstratios Katsianos
- 1(st) Department of Cardiology, University of Athens, 'Hippokration' Hospital, Athens, Greece; 3(rd) Department of Cardiology, University of Athens, 'Sotiria' Hospital, Athens, Greece
| | - Charalambos Kalantzis
- 1(st) Department of Cardiology, University of Athens, 'Hippokration' Hospital, Athens, Greece
| | - Evelina Bei
- 1(st) Department of Cardiology, University of Athens, 'Hippokration' Hospital, Athens, Greece
| | | | | | | | - Petros Dardas
- Cardiology Department, 'Aghios Loukas' Hospital, Thessaloniki, Greece
| | | | - Afroditi Tzifa
- Cardiology Department, 'Hygeia' Hospital, Athens, Greece
| | | | - Gerasimos Siasos
- 1(st) Department of Cardiology, University of Athens, 'Hippokration' Hospital, Athens, Greece; 3(rd) Department of Cardiology, University of Athens, 'Sotiria' Hospital, Athens, Greece
| | - Dimitrios Tousoulis
- 1(st) Department of Cardiology, University of Athens, 'Hippokration' Hospital, Athens, Greece
| | - Manolis Vavuranakis
- 1(st) Department of Cardiology, University of Athens, 'Hippokration' Hospital, Athens, Greece; 3(rd) Department of Cardiology, University of Athens, 'Sotiria' Hospital, Athens, Greece
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