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Paravalvular leak closure after transcatheter aortic valve replacement with a self‐expanding prosthesis
Author(s) -
Gafoor Sameer,
Franke Jennifer,
Piayda Kerstin,
Lam Simon,
Bertog Stefan,
Vaskelyte Laura,
Hofmann Ilona,
Sievert Horst
Publication year - 2013
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.25176
Subject(s) - medicine , percutaneous , valve replacement , surgery , prosthesis , leak , balloon , cardiac catheterization , cardiology , stenosis , environmental engineering , engineering
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. © 2013 Wiley Periodicals, Inc.