Transcatheter closure of paravalvular leaks using a paravalvular leak device – a prospective Polish registry
Introduction : Transcatheter paravalvular leak closure (TPVLC) has become an established treatment option but is mostly performed with off-label use of different non-dedicated occluders. The first one specifically designed for TPVLC is the paravalvular leak device (PLD – Occlutech). Aim : We prese...
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doaj-a791255261b347879189a931938b59b52020-11-25T01:16:10ZengTermedia Publishing HouseAdvances in Interventional Cardiology1734-93381897-42952016-05-0112212813410.5114/aic.2016.5936327392Transcatheter closure of paravalvular leaks using a paravalvular leak device – a prospective Polish registryGrzegorz SmolkaPiotr PyszMichał KozłowskiMarek JasińskiRadosław GocołTomasz RolederAgnieszka KargulAndrzej OchałaWojciech WojakowskiIntroduction : Transcatheter paravalvular leak closure (TPVLC) has become an established treatment option but is mostly performed with off-label use of different non-dedicated occluders. The first one specifically designed for TPVLC is the paravalvular leak device (PLD – Occlutech). Aim : We present initial short-term results of a prospective registry intended to assess the safety and efficacy of TPVLC with PLD. Material and methods : We screened patients with paravalvular leak (PVL) after surgical valve replacement (SVR). Heart failure symptoms and/or hemolytic anemia were indications for TPVLC. Patients were selected according to PVL anatomy by RT 3D TEE. Only those considered appropriate for closure with a single PLD were enrolled. The procedures were performed via transvascular or transapical access using type W (waist) PLDs only. Results : Thirty patients with 34 PVLs (18 aortic, 16 mitral) were included. We implanted 35 PLDs with a total device success rate of 94.3% (100% for aortic, 88.2% for mitral). The procedural success rate, encompassing device success without in-hospital complications, was 94.1% (100% for aortic, 93.8% for mitral). During the follow-up period we recorded an increase of hemoglobin concentration (3.9 to 4.1 g/dl), red blood count (11.6 to 12.2 M/mm3) and functional improvement by NYHA class. Conclusions : Paravalvular leak device type W is a promising TPVLC device, but meticulous preselection of patients based on imaging of PVL anatomy is a prerequisite. A PLD should only be chosen for channels shorter than 5 mm. Size of the device should match the PVL cross-sectional area without any oversizing. Such an approach facilitates high device and procedural success rates.https://www.termedia.pl/Transcatheter-closure-of-paravalvular-leaks-using-a-paravalvular-leak-device-a-prospective-Polish-registry,35,27392,1,1.htmlpercutaneous closure paravalvular leak occluder prosthetic heart valve |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Grzegorz Smolka Piotr Pysz Michał Kozłowski Marek Jasiński Radosław Gocoł Tomasz Roleder Agnieszka Kargul Andrzej Ochała Wojciech Wojakowski |
spellingShingle |
Grzegorz Smolka Piotr Pysz Michał Kozłowski Marek Jasiński Radosław Gocoł Tomasz Roleder Agnieszka Kargul Andrzej Ochała Wojciech Wojakowski Transcatheter closure of paravalvular leaks using a paravalvular leak device – a prospective Polish registry Advances in Interventional Cardiology percutaneous closure paravalvular leak occluder prosthetic heart valve |
author_facet |
Grzegorz Smolka Piotr Pysz Michał Kozłowski Marek Jasiński Radosław Gocoł Tomasz Roleder Agnieszka Kargul Andrzej Ochała Wojciech Wojakowski |
author_sort |
Grzegorz Smolka |
title |
Transcatheter closure of paravalvular leaks using a paravalvular leak device – a prospective Polish registry |
title_short |
Transcatheter closure of paravalvular leaks using a paravalvular leak device – a prospective Polish registry |
title_full |
Transcatheter closure of paravalvular leaks using a paravalvular leak device – a prospective Polish registry |
title_fullStr |
Transcatheter closure of paravalvular leaks using a paravalvular leak device – a prospective Polish registry |
title_full_unstemmed |
Transcatheter closure of paravalvular leaks using a paravalvular leak device – a prospective Polish registry |
title_sort |
transcatheter closure of paravalvular leaks using a paravalvular leak device – a prospective polish registry |
publisher |
Termedia Publishing House |
series |
Advances in Interventional Cardiology |
issn |
1734-9338 1897-4295 |
publishDate |
2016-05-01 |
description |
Introduction : Transcatheter paravalvular leak closure (TPVLC) has become an established treatment option but is mostly performed with off-label use of different non-dedicated occluders. The first one specifically designed for TPVLC is the paravalvular leak device (PLD – Occlutech).
Aim : We present initial short-term results of a prospective registry intended to assess the safety and efficacy of TPVLC with PLD.
Material and methods : We screened patients with paravalvular leak (PVL) after surgical valve replacement (SVR). Heart failure symptoms and/or hemolytic anemia were indications for TPVLC. Patients were selected according to PVL anatomy by RT 3D TEE. Only those considered appropriate for closure with a single PLD were enrolled. The procedures were performed via transvascular or transapical access using type W (waist) PLDs only.
Results : Thirty patients with 34 PVLs (18 aortic, 16 mitral) were included. We implanted 35 PLDs with a total device success rate of 94.3% (100% for aortic, 88.2% for mitral). The procedural success rate, encompassing device success without in-hospital complications, was 94.1% (100% for aortic, 93.8% for mitral). During the follow-up period we recorded an increase of hemoglobin concentration (3.9 to 4.1 g/dl), red blood count (11.6 to 12.2 M/mm3) and functional improvement by NYHA class.
Conclusions : Paravalvular leak device type W is a promising TPVLC device, but meticulous preselection of patients based on imaging of PVL anatomy is a prerequisite. A PLD should only be chosen for channels shorter than 5 mm. Size of the device should match the PVL cross-sectional area without any oversizing. Such an approach facilitates high device and procedural success rates. |
topic |
percutaneous closure paravalvular leak occluder prosthetic heart valve |
url |
https://www.termedia.pl/Transcatheter-closure-of-paravalvular-leaks-using-a-paravalvular-leak-device-a-prospective-Polish-registry,35,27392,1,1.html |
work_keys_str_mv |
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