Percutaneous Treatment of Mitral Paraprosthetic Regurgitation: an Alternative to Surgery

Paraprosthetic regurgitation occurs in approximately 7%–17% of patients undergoing mitral valve replacement and 2%–10% of patients undergoing aortic valve replacement1,2. Typically, this regurgitation is discrete and does imply major clinical complications; however, when it is moderate or severe, the consequences can be serious, leading to heart failure and/or hemolysis3,4. It is estimated that approximately 1%–5% of cases develop to more clinically severe conditions1,4. The main causes of paraprosthetic regurgitation are calcification of the valvular annulus, infection, suture technique, and size and shape of the prosthesis1,5.Usually, surgical treatment is considered as the first treatment option for symptomatic patients4. In 1992, however, an alternative treatment via percutaneous occlusion of the paravalvular orifice was proposed for cases in which the patient faces high risk from surgical treatment6-8.