Paravalvular leak closure after transcatheter aortic valve replacement with a self-expanding prosthesis

Introduction: Paravalvular leak (PVL) after percutaneous transcatheter aortic valve replacement (TAVR) is associated with significant morbidity and mortality. Percutaneous PVL closure has been reported for balloon-expandable valves but not self-expandable valves. Methods: We conducted a review of ca...

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Hauptverfasser: Gafoor, Sameer (VerfasserIn) , Franke, Jennifer (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 2014
In: Catheterization and cardiovascular interventions
Year: 2013, Jahrgang: 84, Heft: 1, Pages: 147-154
ISSN:1522-726X
DOI:10.1002/ccd.25176
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1002/ccd.25176
Verlag, lizenzpflichtig, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1002/ccd.25176
Volltext
Verfasserangaben:Sameer Gafoor, Jennifer Franke, Kerstin Piayda, Simon Lam, Stefan Bertog, Laura Vaskelyte, Ilona Hofmann, and Horst Sievert

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520 |a Introduction: Paravalvular leak (PVL) after percutaneous transcatheter aortic valve replacement (TAVR) is associated with significant morbidity and mortality. Percutaneous PVL closure has been reported for balloon-expandable valves but not self-expandable valves. Methods: We conducted a review of cases at our center where patients who received TAVR with self-expandable valves and went on to develop severe PVL underwent percutaneous closure. Baseline demographic, TAVR procedural, PVL procedural, and follow-up data were collected. Results: A total of five patients with severe PVL after TAVR with a self-expanding valve underwent percutaneous PVL closure. Four of five patients had a trial of balloon postdilatation after valve deployment and had significant persistent PVL. In all five patients, PVL went from moderate-severe to mild-moderate PVL. There were no adverse events. Conclusion: Percutaneous PVL closure for severe PVL self-expanding valve for TAVR is a safe and efficacious procedure. Procedural technique involves transesophageal guidance, a high approach through the valve struts, deployment of an appropriate size device, and careful monitoring. This method may be part of the algorithm for severe PVL after TAVR. 
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