Abstract
Prosthetic paravalvular leaks (PVLs) are well-recognized complications of surgical and transcatheter valve replacement. Various series have demonstrated that 5–15% of all surgical valve replacements are complicated by some form of PVL and, specifically, 40–70% of patients who undergo transcatheter aortic valve replacement. Significant PVL could lead to major clinical and hemodynamic consequences and impacts long-term survival.Reoperation for PVL is associated with a high recurrence rate and carries with it significant morbidity and mortality risks. Alternatively, efforts have been made to seal PVL percutaneously by delivering occluders at the site of leak, preventing or reducing the amount of regurgitation. Percutaneous approach is now an established therapy for symptomatic patients with PVL and is frequently considered as primary therapy for eligible patients. To deliver these devices, multiple approaches have been used, including retrograde transaortic, anterograde transseptal and more recently transapical (TA). This chapter reviews the utility and technique of transcatheter mitral paravalvular leak closure using surgical and percutaneous transapical approaches.
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References
Davila-Roman VG, Waggoner AD, Kennard ED, Holubkov R, Jamieson WR, Englberger L, et al. Prevalence and severity of paravalvular regurgitation in the artificial valve endocarditis reduction trial (AVERT) echocardiography study. J Am Coll Cardiol. 2004;44(7):1467–72. Epub 2004/10/07.
Kodali SK, Williams MR, Smith CR, Svensson LG, Webb JG, Makkar RR, et al. Two-year outcomes after transcatheter or surgical aortic-valve replacement. N Engl J Med. 2012;366(18):1686–95. Epub 2012/03/27.
Hahn RT, Pibarot P, Stewart WJ, Weissman NJ, Gopalakrishnan D, Keane MG, et al. Comparison of transcatheter and surgical aortic valve replacement in severe aortic stenosis: a longitudinal study of echocardiography parameters in cohort a of the PARTNER trial (placement of aortic transcatheter valves). J Am Coll Cardiol. 2013;61(25):2514–21. Epub 2013/04/30.
Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP III, Guyton RA, et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. J Thorac Cardiovasc Surg. 2014;148(1):e1–e132. Epub 2014/06/19.
Brock R, Milstein BB, Ross DN. Percutaneous left ventricular puncture in the assessment of aortic stenosis. Thorax. 1956;11(3):163–71. Epub 1956/09/01.
Jelnin V, Dudiy Y, Einhorn BN, Kronzon I, Cohen HA, Ruiz CE. Clinical experience with percutaneous left ventricular transapical access for interventions in structural heart defects a safe access and secure exit. JACC Cardiovasc Interv. 2011;4(8):868–74. Epub 2011/08/20.
Ruiz CE, Jelnin V, Kronzon I, Dudiy Y, Del Valle-Fernandez R, Einhorn BN, et al. Clinical outcomes in patients undergoing percutaneous closure of periprosthetic paravalvular leaks. J Am Coll Cardiol. 2011;58(21):2210–7. Epub 2011/11/15.
Levy MJ, Lillehei CW. Percutaneous direct cardiac Catheterization. A new method, with results in 122 patients. N Engl J Med. 1964;271:273–80. Epub 1964/08/01.
Kliger C, Jelnin V, Sharma S, Panagopoulos G, Einhorn BN, Kumar R, et al. CT angiography-fluoroscopy fusion imaging for percutaneous transapical access. JACC Cardiovasc Imaging. 2014;7(2):169–77. Epub 2014/01/15.
Davidavicius G, Rucinskas K, Drasutiene A, Samalavicius R, Bilkis V, Zakarkaite D, et al. Hybrid approach for transcatheter paravalvular leak closure of mitral prosthesis in high-risk patients through transapical access. J Thorac Cardiovasc Surg. 2014;148(5):1965–9. Epub 2014/06/04.
Goktekin O, Vatankulu MA, Tasal A, Sonmez O, Basel H, Topuz U, et al. Transcatheter trans-apical closure of paravalvular mitral and aortic leaks using a new device: first in man experience. Catheter Cardiovasc Interv. 2014;83(2):308–14. Epub 2013/05/25.
Goktekin O, Vatankulu MA, Ozhan H, Ay Y, Ergelen M, Tasal A, et al. Early experience of percutaneous paravalvular leak closure using a novel Occlutech occluder. EuroIntervention. 2016;11(10):1195–200. Epub 2016/02/22.
Smolka G, Pysz P, Jasinski M, Roleder T, Peszek-Przybyla E, Ochala A, et al. Multiplug paravalvular leak closure using Amplatzer vascular plugs III: a prospective registry. Catheter Cardiovasc Interv. 2016;87(3):478–87. Epub 2015/05/13.
Cruz-Gonzalez I, Rama-Merchan JC, Arribas-Jimenez A, Rodriguez-Collado J, Martin-Moreiras J, Cascon-Bueno M, et al. Paravalvular leak closure with the Amplatzer vascular plug III device: immediate and short-term results. Rev Esp Cardiol (Engl Ed). 2014;67(8):608–14. Epub 2014/07/20.
Swaans MJ, Post MC, van der Ven HA, Heijmen RH, Budts W, ten Berg JM. Transapical treatment of paravalvular leaks in patients with a logistic EuroSCORE of more than 15%: acute and 3-month outcomes of a “proof of concept” study. Catheter Cardiovasc Interv. 2012;79(5):741–7. Epub 2011/08/02.
Brown SC, Boshoff DE, Rega F, Eyskens B, Budts W, Heidbuchel H, et al. Transapical left ventricular access for difficult to reach interventional targets in the left heart. Catheter Cardiovasc Interv. 2009;74(1):137–42. Epub 2009/05/01.
Sorajja P, Cabalka AK, Hagler DJ, Rihal CS. Percutaneous repair of paravalvular prosthetic regurgitation: acute and 30-day outcomes in 115 patients. Circ Cardiovasc Interv. 2011;4(4):314–21. Epub 2011/07/28.
Ferrari E. Apical access and closure devices for transapical transcatheter heart valve procedures. Swiss Med Wkly. 2016;146:w14237. Epub 2016/02/24.
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Suradi, H.S., Syed, A., Cao, QL., Hijazi, Z.M. (2017). Mitral Paravalvular Leak Closure: The Apical Approach. In: Smolka, G., Wojakowski, W., Tendera, M. (eds) Transcatheter Paravalvular Leak Closure. Springer, Singapore. https://doi.org/10.1007/978-981-10-5400-6_8
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DOI: https://doi.org/10.1007/978-981-10-5400-6_8
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