Percutaneous paravalvular leak closure.
Percutaneous paravalvular leak closure is increasingly being performed as an alternative to reoperation in patients with symptomatic prosthetic paravalvular regurgitation. This article reviews the pathogenesis of paravalvular leaks and percutaneous techniques for closure. Newer multimodality imaging techniques, including 3-dimensional (3D) transesophageal echocardiography and 3D/4D computed tomographic angiography, allow improved preprocedural planning and intraprocedural guidance. Specific techniques can be used for challenging patient anatomy and larger paravalvular leaks. Outcomes from experienced centers show acceptable rates of technical and clinical success, with lower procedural morbidity than reoperation.
Department of Structural and Congenital Heart Disease, Lenox Hill Heart and Vascular Institute, North Shore/LIJ Health System, New York, NY 10021-10075, USA.
Robert
R
Kumar
Vladimir
V
Jelnin
Chad
C
Kliger
Carlos E
CE
Ruiz
D006328:Cardiac Catheterization / Q000379:methods*; D057791:Cardiac Imaging Techniques; D006349:Heart Valve Diseases / Q000628:therapy*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D055989:Septal Occluder Device
Congestive heart failure; Hemolytic anemia; Paravalvular regurgitation; Percutaneous closure; Prosthetic valve