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- Title
Device Closure of Paravalvular Regurgitation- A Single-Center Experience from a Tertiary Care Centre in South India.
- Authors
Logesh; Speedie, Abraham; George, Oommen K.; Krupa, Jesu
- Abstract
Paravalvular regurgitation/leak (PVL) frequently occurs following prosthetic cardiac valve implantation. The incidence of PVL following mitral valve replacements (MVRs) is 5% to 17% and is about 5% to 10% after aortic valve replacements (AVRs). Symptoms of PVL are either due to heart failure or haemolysis. Surgery for PVL is associated with significant morbidity and mortality. Percutaneous closure of PVLs has emerged as an attractive alternative to surgery. An aortic PVL is closed using less complicated techniques via the retrograde transfemoral approach. Transcatheter closure of mitral PVLs is technically challenging and requires more complex catheter techniques than aortic PVLs. Transoesophageal echocardiogram (TEE) guidance in mitral leaks is mandatory during all stages of the procedure. In this cohort, one patient had aortic PVL, which was treated using a retrograde transfemoral approach. Four patients had mitral PVLs, and transseptal puncture was done in all four patients. In one mitral PVL patient, the device closure was done using the antegrade transseptal technique. In the remaining three mitral PVL patients, we utilised the arteriovenous loop technique for device closure. Procedural success was noted in four out of five patients. Achieving a mild or lesser severity of PVL at follow-up is key to a good outcome. Residual leak post-closure determines major adverse cardiovascular events (MACE). The degree of the leak at follow-up is independently associated with both MACE and death
- Subjects
MAJOR adverse cardiovascular events; AORTIC valve transplantation; HEART valves; MITRAL valve; HEART failure
- Publication
Journal of Cardiovascular Disease Research (Journal of Cardiovascular Disease Research), 2024, Vol 15, Issue 7, p683
- ISSN
0975-3583
- Publication type
Article