title: Percutaneous Closure of Paravalvular Leaks: A Systematic Review.
abstract: Paravalvular leak (PVL) is an uncommon yet serious complication associated with the implantation of mechanical or bioprosthetic surgical valves and more recently recognized with transcatheter aortic valves implantation (TAVI). A significant number of patients will present with symptoms of congestive heart failure or haemolytic anaemia due to PVL and need further surgical or percutaneous treatment. Until recently, surgery has been the only available therapy for the treatment of clinically significant PVLs despite the significant morbidity and mortality associated with re-operation. Percutaneous treatment of PVLs has emerged as a safe and less invasive alternative, with low complication rates and high technical and clinical success rates. However, it is a complex procedure, which needs to be performed by an experienced team of interventional cardiologists and echocardiographers. This review discusses the current understanding of PVLs, including the utility of imaging techniques in PVL diagnosis and treatment, and the principles, outcomes and complications of transcatheter therapy of PVLs.
authors.affiliation: University Hospital of Salamanca, IBSAL, Salamanca, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Cruz-Gonzalez
authors.affiliation: University Hospital of Salamanca, IBSAL, Salamanca, Spain.
authors.forename: Juan C
authors.initials: JC
authors.lastname: Rama-Merchan
authors.affiliation: Queen Elizabeth Hospital, University Hospitals Birmingham and Institute of Translational Medicine, University of Birmingham, United Kingdom.
authors.forename: Patrick A
authors.initials: PA
authors.lastname: Calvert
authors.affiliation: University Hospital of Salamanca, IBSAL, Salamanca, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Rodríguez-Collado
authors.affiliation: University Hospital of Salamanca, IBSAL, Salamanca, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Barreiro-Pérez
authors.affiliation: University Hospital of Salamanca, IBSAL, Salamanca, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Martín-Moreiras
authors.affiliation: University Hospital of Salamanca, IBSAL, Salamanca, Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Diego-Nieto
authors.affiliation: Sussex Cardiac Centre, Brighton and Sussex University Hospitals, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Hildick-Smith
authors.affiliation: University Hospital of Salamanca, IBSAL, Salamanca, Spain.
authors.forename: Pedro L
authors.initials: PL
authors.lastname: Sánchez
mesh_terms: D057868:Anastomotic Leak / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D006801:Humans; D011475:Prosthesis Failure; D012086:Reoperation / Q000379:methods*; D058106:Wound Closure Techniques