title: Percutaneous Device Closure of Paravalvular Leak: Combined Experience From the United Kingdom and Ireland.
abstract: BACKGROUND
  Paravalvular leak (PVL) occurs in 5% to 17% of patients following surgical valve replacement. Percutaneous device closure represents an alternative to repeat surgery.
  
  
  METHODS
  All UK and Ireland centers undertaking percutaneous PVL closure submitted data to the UK PVL Registry. Data were analyzed for association with death and major adverse cardiovascular events (MACE) at follow-up.
  
  
  RESULTS
  Three hundred eight PVL closure procedures were attempted in 259 patients in 20 centers (2004-2015). Patient age was 67±13 years; 28% were female. The main indications for closure were heart failure (80%) and hemolysis (16%). Devices were successfully implanted in 91% of patients, via radial (7%), femoral arterial (52%), femoral venous (33%), and apical (7%) approaches. Nineteen percent of patients required repeat procedures. The target valve was mitral (44%), aortic (48%), both (2%), pulmonic (0.4%), or transcatheter aortic valve replacement (5%). Preprocedural leak was severe (61%), moderate (34%), or mild (5.7%) and was multiple in 37%. PVL improved postprocedure (P<0.001) and was none (33.3%), mild (41.4%), moderate (18.6%), or severe (6.7%) at last follow-up. Mean New York Heart Association class improved from 2.7±0.8 preprocedure to 1.6±0.8 (P<0.001) after a median follow-up of 110 (7-452) days. Hospital mortality was 2.9% (elective), 6.8% (in-hospital urgent), and 50% (emergency) (P<0.001). MACE during follow-up included death (16%), valve surgery (6%), late device embolization (0.4%), and new hemolysis requiring transfusion (1.6%). Mitral PVL was associated with higher MACE (hazard ratio [HR], 1.83; P=0.011). Factors independently associated with death were the degree of persisting leak (HR, 2.87; P=0.037), New York Heart Association class (HR, 2.00; P=0.015) at follow-up and baseline creatinine (HR, 8.19; P=0.001). The only factor independently associated with MACE was the degree of persisting leak at follow-up (HR, 3.01; P=0.002).
  
  
  CONCLUSIONS
  Percutaneous closure of PVL is an effective procedure that improves PVL severity and symptoms. Severity of persisting leak at follow-up is independently associated with both MACE and death. Percutaneous closure should be considered as an alternative to repeat surgery.
authors: From Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (P.A.C., L.S., W.R.D., B.S.R.); Queen Elizabeth Hospital, University Hospitals Birmingham, United Kingdom (P.A.C., P.L., P.C., J.d.G.); Institute of Translational Medicine, University of Birmingham, United Kingdom (P.A.C., P.C.); Royal Infirmary of Edinburgh, Edinburgh, United Kingdeom (D.B.N.); Imperial College NHS Trust, London, United Kingdom (I.S.M.); Evelina Children's Hospital, London, United Kingdom (S.A.Q., G.M.); The Heart Hospital, London, United Kingdom (M.M.); Nottingham University Hospital, Nottingham, United Kingdom (R.H., H.R.K.); Bristol Heart Institute, Bristol, United Kingdom (M.T., Y.I.); University Hospital Coventry, Coventry, United Kingdom (M.B.); Mater Misericordiae University Hospital, Dublin, Ireland (K.P.W.); Mater Private Hospital, Dublin, Ireland (I.C.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (L.M., S.K.A.); Golden Jubilee National Hospital, Glasgow, United Kingdom (N.L.W.); Leeds General Infirmary, Leeds, United Kingdom (J.T.); Royal Victoria Hospital, Belfast, United Kingdom (M.S.S.); Manchester Royal Infirmary, Manchester, United Kingdom (V.S.M.); Castle Hill Hospital, Hull, United Kingdom (A.H.); King's College London, United Kingdom (P.A.M.); John Radcliffe Hospital, Oxford, United Kingdom (M.J.D., J.O.M.O., O.O.); and Royal Sussex County Hospital, Brighton, United Kingdom (S.S.C., D.H.-S.). patrick.calvert@papworth.nhs.uk.
authors: Patrick A
authors: PA
authors: Calvert
authors: From Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (P.A.C., L.S., W.R.D., B.S.R.); Queen Elizabeth Hospital, University Hospitals Birmingham, United Kingdom (P.A.C., P.L., P.C., J.d.G.); Institute of Translational Medicine, University of Birmingham, United Kingdom (P.A.C., P.C.); Royal Infirmary of Edinburgh, Edinburgh, United Kingdeom (D.B.N.); Imperial College NHS Trust, London, United Kingdom (I.S.M.); Evelina Children's Hospital, London, United Kingdom (S.A.Q., G.M.); The Heart Hospital, London, United Kingdom (M.M.); Nottingham University Hospital, Nottingham, United Kingdom (R.H., H.R.K.); Bristol Heart Institute, Bristol, United Kingdom (M.T., Y.I.); University Hospital Coventry, Coventry, United Kingdom (M.B.); Mater Misericordiae University Hospital, Dublin, Ireland (K.P.W.); Mater Private Hospital, Dublin, Ireland (I.C.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (L.M., S.K.A.); Golden Jubilee National Hospital, Glasgow, United Kingdom (N.L.W.); Leeds General Infirmary, Leeds, United Kingdom (J.T.); Royal Victoria Hospital, Belfast, United Kingdom (M.S.S.); Manchester Royal Infirmary, Manchester, United Kingdom (V.S.M.); Castle Hill Hospital, Hull, United Kingdom (A.H.); King's College London, United Kingdom (P.A.M.); John Radcliffe Hospital, Oxford, United Kingdom (M.J.D., J.O.M.O., O.O.); and Royal Sussex County Hospital, Brighton, United Kingdom (S.S.C., D.H.-S.).
authors: David B
authors: DB
authors: Northridge
authors: From Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (P.A.C., L.S., W.R.D., B.S.R.); Queen Elizabeth Hospital, University Hospitals Birmingham, United Kingdom (P.A.C., P.L., P.C., J.d.G.); Institute of Translational Medicine, University of Birmingham, United Kingdom (P.A.C., P.C.); Royal Infirmary of Edinburgh, Edinburgh, United Kingdeom (D.B.N.); Imperial College NHS Trust, London, United Kingdom (I.S.M.); Evelina Children's Hospital, London, United Kingdom (S.A.Q., G.M.); The Heart Hospital, London, United Kingdom (M.M.); Nottingham University Hospital, Nottingham, United Kingdom (R.H., H.R.K.); Bristol Heart Institute, Bristol, United Kingdom (M.T., Y.I.); University Hospital Coventry, Coventry, United Kingdom (M.B.); Mater Misericordiae University Hospital, Dublin, Ireland (K.P.W.); Mater Private Hospital, Dublin, Ireland (I.C.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (L.M., S.K.A.); Golden Jubilee National Hospital, Glasgow, United Kingdom (N.L.W.); Leeds General Infirmary, Leeds, United Kingdom (J.T.); Royal Victoria Hospital, Belfast, United Kingdom (M.S.S.); Manchester Royal Infirmary, Manchester, United Kingdom (V.S.M.); Castle Hill Hospital, Hull, United Kingdom (A.H.); King's College London, United Kingdom (P.A.M.); John Radcliffe Hospital, Oxford, United Kingdom (M.J.D., J.O.M.O., O.O.); and Royal Sussex County Hospital, Brighton, United Kingdom (S.S.C., D.H.-S.).
authors: Iqbal S
authors: IS
authors: Malik
authors: From Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (P.A.C., L.S., W.R.D., B.S.R.); Queen Elizabeth Hospital, University Hospitals Birmingham, United Kingdom (P.A.C., P.L., P.C., J.d.G.); Institute of Translational Medicine, University of Birmingham, United Kingdom (P.A.C., P.C.); Royal Infirmary of Edinburgh, Edinburgh, United Kingdeom (D.B.N.); Imperial College NHS Trust, London, United Kingdom (I.S.M.); Evelina Children's Hospital, London, United Kingdom (S.A.Q., G.M.); The Heart Hospital, London, United Kingdom (M.M.); Nottingham University Hospital, Nottingham, United Kingdom (R.H., H.R.K.); Bristol Heart Institute, Bristol, United Kingdom (M.T., Y.I.); University Hospital Coventry, Coventry, United Kingdom (M.B.); Mater Misericordiae University Hospital, Dublin, Ireland (K.P.W.); Mater Private Hospital, Dublin, Ireland (I.C.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (L.M., S.K.A.); Golden Jubilee National Hospital, Glasgow, United Kingdom (N.L.W.); Leeds General Infirmary, Leeds, United Kingdom (J.T.); Royal Victoria Hospital, Belfast, United Kingdom (M.S.S.); Manchester Royal Infirmary, Manchester, United Kingdom (V.S.M.); Castle Hill Hospital, Hull, United Kingdom (A.H.); King's College London, United Kingdom (P.A.M.); John Radcliffe Hospital, Oxford, United Kingdom (M.J.D., J.O.M.O., O.O.); and Royal Sussex County Hospital, Brighton, United Kingdom (S.S.C., D.H.-S.).
authors: Leonard
authors: L
authors: Shapiro
authors: From Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (P.A.C., L.S., W.R.D., B.S.R.); Queen Elizabeth Hospital, University Hospitals Birmingham, United Kingdom (P.A.C., P.L., P.C., J.d.G.); Institute of Translational Medicine, University of Birmingham, United Kingdom (P.A.C., P.C.); Royal Infirmary of Edinburgh, Edinburgh, United Kingdeom (D.B.N.); Imperial College NHS Trust, London, United Kingdom (I.S.M.); Evelina Children's Hospital, London, United Kingdom (S.A.Q., G.M.); The Heart Hospital, London, United Kingdom (M.M.); Nottingham University Hospital, Nottingham, United Kingdom (R.H., H.R.K.); Bristol Heart Institute, Bristol, United Kingdom (M.T., Y.I.); University Hospital Coventry, Coventry, United Kingdom (M.B.); Mater Misericordiae University Hospital, Dublin, Ireland (K.P.W.); Mater Private Hospital, Dublin, Ireland (I.C.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (L.M., S.K.A.); Golden Jubilee National Hospital, Glasgow, United Kingdom (N.L.W.); Leeds General Infirmary, Leeds, United Kingdom (J.T.); Royal Victoria Hospital, Belfast, United Kingdom (M.S.S.); Manchester Royal Infirmary, Manchester, United Kingdom (V.S.M.); Castle Hill Hospital, Hull, United Kingdom (A.H.); King's College London, United Kingdom (P.A.M.); John Radcliffe Hospital, Oxford, United Kingdom (M.J.D., J.O.M.O., O.O.); and Royal Sussex County Hospital, Brighton, United Kingdom (S.S.C., D.H.-S.).
authors: Peter
authors: P
authors: Ludman
authors: From Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (P.A.C., L.S., W.R.D., B.S.R.); Queen Elizabeth Hospital, University Hospitals Birmingham, United Kingdom (P.A.C., P.L., P.C., J.d.G.); Institute of Translational Medicine, University of Birmingham, United Kingdom (P.A.C., P.C.); Royal Infirmary of Edinburgh, Edinburgh, United Kingdeom (D.B.N.); Imperial College NHS Trust, London, United Kingdom (I.S.M.); Evelina Children's Hospital, London, United Kingdom (S.A.Q., G.M.); The Heart Hospital, London, United Kingdom (M.M.); Nottingham University Hospital, Nottingham, United Kingdom (R.H., H.R.K.); Bristol Heart Institute, Bristol, United Kingdom (M.T., Y.I.); University Hospital Coventry, Coventry, United Kingdom (M.B.); Mater Misericordiae University Hospital, Dublin, Ireland (K.P.W.); Mater Private Hospital, Dublin, Ireland (I.C.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (L.M., S.K.A.); Golden Jubilee National Hospital, Glasgow, United Kingdom (N.L.W.); Leeds General Infirmary, Leeds, United Kingdom (J.T.); Royal Victoria Hospital, Belfast, United Kingdom (M.S.S.); Manchester Royal Infirmary, Manchester, United Kingdom (V.S.M.); Castle Hill Hospital, Hull, United Kingdom (A.H.); King's College London, United Kingdom (P.A.M.); John Radcliffe Hospital, Oxford, United Kingdom (M.J.D., J.O.M.O., O.O.); and Royal Sussex County Hospital, Brighton, United Kingdom (S.S.C., D.H.-S.).
authors: Shakeel A
authors: SA
authors: Qureshi
authors: From Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (P.A.C., L.S., W.R.D., B.S.R.); Queen Elizabeth Hospital, University Hospitals Birmingham, United Kingdom (P.A.C., P.L., P.C., J.d.G.); Institute of Translational Medicine, University of Birmingham, United Kingdom (P.A.C., P.C.); Royal Infirmary of Edinburgh, Edinburgh, United Kingdeom (D.B.N.); Imperial College NHS Trust, London, United Kingdom (I.S.M.); Evelina Children's Hospital, London, United Kingdom (S.A.Q., G.M.); The Heart Hospital, London, United Kingdom (M.M.); Nottingham University Hospital, Nottingham, United Kingdom (R.H., H.R.K.); Bristol Heart Institute, Bristol, United Kingdom (M.T., Y.I.); University Hospital Coventry, Coventry, United Kingdom (M.B.); Mater Misericordiae University Hospital, Dublin, Ireland (K.P.W.); Mater Private Hospital, Dublin, Ireland (I.C.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (L.M., S.K.A.); Golden Jubilee National Hospital, Glasgow, United Kingdom (N.L.W.); Leeds General Infirmary, Leeds, United Kingdom (J.T.); Royal Victoria Hospital, Belfast, United Kingdom (M.S.S.); Manchester Royal Infirmary, Manchester, United Kingdom (V.S.M.); Castle Hill Hospital, Hull, United Kingdom (A.H.); King's College London, United Kingdom (P.A.M.); John Radcliffe Hospital, Oxford, United Kingdom (M.J.D., J.O.M.O., O.O.); and Royal Sussex County Hospital, Brighton, United Kingdom (S.S.C., D.H.-S.).
authors: Michael
authors: M
authors: Mullen
authors: From Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (P.A.C., L.S., W.R.D., B.S.R.); Queen Elizabeth Hospital, University Hospitals Birmingham, United Kingdom (P.A.C., P.L., P.C., J.d.G.); Institute of Translational Medicine, University of Birmingham, United Kingdom (P.A.C., P.C.); Royal Infirmary of Edinburgh, Edinburgh, United Kingdeom (D.B.N.); Imperial College NHS Trust, London, United Kingdom (I.S.M.); Evelina Children's Hospital, London, United Kingdom (S.A.Q., G.M.); The Heart Hospital, London, United Kingdom (M.M.); Nottingham University Hospital, Nottingham, United Kingdom (R.H., H.R.K.); Bristol Heart Institute, Bristol, United Kingdom (M.T., Y.I.); University Hospital Coventry, Coventry, United Kingdom (M.B.); Mater Misericordiae University Hospital, Dublin, Ireland (K.P.W.); Mater Private Hospital, Dublin, Ireland (I.C.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (L.M., S.K.A.); Golden Jubilee National Hospital, Glasgow, United Kingdom (N.L.W.); Leeds General Infirmary, Leeds, United Kingdom (J.T.); Royal Victoria Hospital, Belfast, United Kingdom (M.S.S.); Manchester Royal Infirmary, Manchester, United Kingdom (V.S.M.); Castle Hill Hospital, Hull, United Kingdom (A.H.); King's College London, United Kingdom (P.A.M.); John Radcliffe Hospital, Oxford, United Kingdom (M.J.D., J.O.M.O., O.O.); and Royal Sussex County Hospital, Brighton, United Kingdom (S.S.C., D.H.-S.).
authors: Robert
authors: R
authors: Henderson
authors: From Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (P.A.C., L.S., W.R.D., B.S.R.); Queen Elizabeth Hospital, University Hospitals Birmingham, United Kingdom (P.A.C., P.L., P.C., J.d.G.); Institute of Translational Medicine, University of Birmingham, United Kingdom (P.A.C., P.C.); Royal Infirmary of Edinburgh, Edinburgh, United Kingdeom (D.B.N.); Imperial College NHS Trust, London, United Kingdom (I.S.M.); Evelina Children's Hospital, London, United Kingdom (S.A.Q., G.M.); The Heart Hospital, London, United Kingdom (M.M.); Nottingham University Hospital, Nottingham, United Kingdom (R.H., H.R.K.); Bristol Heart Institute, Bristol, United Kingdom (M.T., Y.I.); University Hospital Coventry, Coventry, United Kingdom (M.B.); Mater Misericordiae University Hospital, Dublin, Ireland (K.P.W.); Mater Private Hospital, Dublin, Ireland (I.C.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (L.M., S.K.A.); Golden Jubilee National Hospital, Glasgow, United Kingdom (N.L.W.); Leeds General Infirmary, Leeds, United Kingdom (J.T.); Royal Victoria Hospital, Belfast, United Kingdom (M.S.S.); Manchester Royal Infirmary, Manchester, United Kingdom (V.S.M.); Castle Hill Hospital, Hull, United Kingdom (A.H.); King's College London, United Kingdom (P.A.M.); John Radcliffe Hospital, Oxford, United Kingdom (M.J.D., J.O.M.O., O.O.); and Royal Sussex County Hospital, Brighton, United Kingdom (S.S.C., D.H.-S.).
authors: Mark
authors: M
authors: Turner
authors: From Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (P.A.C., L.S., W.R.D., B.S.R.); Queen Elizabeth Hospital, University Hospitals Birmingham, United Kingdom (P.A.C., P.L., P.C., J.d.G.); Institute of Translational Medicine, University of Birmingham, United Kingdom (P.A.C., P.C.); Royal Infirmary of Edinburgh, Edinburgh, United Kingdeom (D.B.N.); Imperial College NHS Trust, London, United Kingdom (I.S.M.); Evelina Children's Hospital, London, United Kingdom (S.A.Q., G.M.); The Heart Hospital, London, United Kingdom (M.M.); Nottingham University Hospital, Nottingham, United Kingdom (R.H., H.R.K.); Bristol Heart Institute, Bristol, United Kingdom (M.T., Y.I.); University Hospital Coventry, Coventry, United Kingdom (M.B.); Mater Misericordiae University Hospital, Dublin, Ireland (K.P.W.); Mater Private Hospital, Dublin, Ireland (I.C.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (L.M., S.K.A.); Golden Jubilee National Hospital, Glasgow, United Kingdom (N.L.W.); Leeds General Infirmary, Leeds, United Kingdom (J.T.); Royal Victoria Hospital, Belfast, United Kingdom (M.S.S.); Manchester Royal Infirmary, Manchester, United Kingdom (V.S.M.); Castle Hill Hospital, Hull, United Kingdom (A.H.); King's College London, United Kingdom (P.A.M.); John Radcliffe Hospital, Oxford, United Kingdom (M.J.D., J.O.M.O., O.O.); and Royal Sussex County Hospital, Brighton, United Kingdom (S.S.C., D.H.-S.).
authors: Martin
authors: M
authors: Been
authors: From Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (P.A.C., L.S., W.R.D., B.S.R.); Queen Elizabeth Hospital, University Hospitals Birmingham, United Kingdom (P.A.C., P.L., P.C., J.d.G.); Institute of Translational Medicine, University of Birmingham, United Kingdom (P.A.C., P.C.); Royal Infirmary of Edinburgh, Edinburgh, United Kingdeom (D.B.N.); Imperial College NHS Trust, London, United Kingdom (I.S.M.); Evelina Children's Hospital, London, United Kingdom (S.A.Q., G.M.); The Heart Hospital, London, United Kingdom (M.M.); Nottingham University Hospital, Nottingham, United Kingdom (R.H., H.R.K.); Bristol Heart Institute, Bristol, United Kingdom (M.T., Y.I.); University Hospital Coventry, Coventry, United Kingdom (M.B.); Mater Misericordiae University Hospital, Dublin, Ireland (K.P.W.); Mater Private Hospital, Dublin, Ireland (I.C.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (L.M., S.K.A.); Golden Jubilee National Hospital, Glasgow, United Kingdom (N.L.W.); Leeds General Infirmary, Leeds, United Kingdom (J.T.); Royal Victoria Hospital, Belfast, United Kingdom (M.S.S.); Manchester Royal Infirmary, Manchester, United Kingdom (V.S.M.); Castle Hill Hospital, Hull, United Kingdom (A.H.); King's College London, United Kingdom (P.A.M.); John Radcliffe Hospital, Oxford, United Kingdom (M.J.D., J.O.M.O., O.O.); and Royal Sussex County Hospital, Brighton, United Kingdom (S.S.C., D.H.-S.).
authors: Kevin P
authors: KP
authors: Walsh
authors: From Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (P.A.C., L.S., W.R.D., B.S.R.); Queen Elizabeth Hospital, University Hospitals Birmingham, United Kingdom (P.A.C., P.L., P.C., J.d.G.); Institute of Translational Medicine, University of Birmingham, United Kingdom (P.A.C., P.C.); Royal Infirmary of Edinburgh, Edinburgh, United Kingdeom (D.B.N.); Imperial College NHS Trust, London, United Kingdom (I.S.M.); Evelina Children's Hospital, London, United Kingdom (S.A.Q., G.M.); The Heart Hospital, London, United Kingdom (M.M.); Nottingham University Hospital, Nottingham, United Kingdom (R.H., H.R.K.); Bristol Heart Institute, Bristol, United Kingdom (M.T., Y.I.); University Hospital Coventry, Coventry, United Kingdom (M.B.); Mater Misericordiae University Hospital, Dublin, Ireland (K.P.W.); Mater Private Hospital, Dublin, Ireland (I.C.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (L.M., S.K.A.); Golden Jubilee National Hospital, Glasgow, United Kingdom (N.L.W.); Leeds General Infirmary, Leeds, United Kingdom (J.T.); Royal Victoria Hospital, Belfast, United Kingdom (M.S.S.); Manchester Royal Infirmary, Manchester, United Kingdom (V.S.M.); Castle Hill Hospital, Hull, United Kingdom (A.H.); King's College London, United Kingdom (P.A.M.); John Radcliffe Hospital, Oxford, United Kingdom (M.J.D., J.O.M.O., O.O.); and Royal Sussex County Hospital, Brighton, United Kingdom (S.S.C., D.H.-S.).
authors: Ivan
authors: I
authors: Casserly
authors: From Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (P.A.C., L.S., W.R.D., B.S.R.); Queen Elizabeth Hospital, University Hospitals Birmingham, United Kingdom (P.A.C., P.L., P.C., J.d.G.); Institute of Translational Medicine, University of Birmingham, United Kingdom (P.A.C., P.C.); Royal Infirmary of Edinburgh, Edinburgh, United Kingdeom (D.B.N.); Imperial College NHS Trust, London, United Kingdom (I.S.M.); Evelina Children's Hospital, London, United Kingdom (S.A.Q., G.M.); The Heart Hospital, London, United Kingdom (M.M.); Nottingham University Hospital, Nottingham, United Kingdom (R.H., H.R.K.); Bristol Heart Institute, Bristol, United Kingdom (M.T., Y.I.); University Hospital Coventry, Coventry, United Kingdom (M.B.); Mater Misericordiae University Hospital, Dublin, Ireland (K.P.W.); Mater Private Hospital, Dublin, Ireland (I.C.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (L.M., S.K.A.); Golden Jubilee National Hospital, Glasgow, United Kingdom (N.L.W.); Leeds General Infirmary, Leeds, United Kingdom (J.T.); Royal Victoria Hospital, Belfast, United Kingdom (M.S.S.); Manchester Royal Infirmary, Manchester, United Kingdom (V.S.M.); Castle Hill Hospital, Hull, United Kingdom (A.H.); King's College London, United Kingdom (P.A.M.); John Radcliffe Hospital, Oxford, United Kingdom (M.J.D., J.O.M.O., O.O.); and Royal Sussex County Hospital, Brighton, United Kingdom (S.S.C., D.H.-S.).
authors: Lindsay
authors: L
authors: Morrison
authors: From Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (P.A.C., L.S., W.R.D., B.S.R.); Queen Elizabeth Hospital, University Hospitals Birmingham, United Kingdom (P.A.C., P.L., P.C., J.d.G.); Institute of Translational Medicine, University of Birmingham, United Kingdom (P.A.C., P.C.); Royal Infirmary of Edinburgh, Edinburgh, United Kingdeom (D.B.N.); Imperial College NHS Trust, London, United Kingdom (I.S.M.); Evelina Children's Hospital, London, United Kingdom (S.A.Q., G.M.); The Heart Hospital, London, United Kingdom (M.M.); Nottingham University Hospital, Nottingham, United Kingdom (R.H., H.R.K.); Bristol Heart Institute, Bristol, United Kingdom (M.T., Y.I.); University Hospital Coventry, Coventry, United Kingdom (M.B.); Mater Misericordiae University Hospital, Dublin, Ireland (K.P.W.); Mater Private Hospital, Dublin, Ireland (I.C.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (L.M., S.K.A.); Golden Jubilee National Hospital, Glasgow, United Kingdom (N.L.W.); Leeds General Infirmary, Leeds, United Kingdom (J.T.); Royal Victoria Hospital, Belfast, United Kingdom (M.S.S.); Manchester Royal Infirmary, Manchester, United Kingdom (V.S.M.); Castle Hill Hospital, Hull, United Kingdom (A.H.); King's College London, United Kingdom (P.A.M.); John Radcliffe Hospital, Oxford, United Kingdom (M.J.D., J.O.M.O., O.O.); and Royal Sussex County Hospital, Brighton, United Kingdom (S.S.C., D.H.-S.).
authors: Nicola L
authors: NL
authors: Walker
authors: From Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (P.A.C., L.S., W.R.D., B.S.R.); Queen Elizabeth Hospital, University Hospitals Birmingham, United Kingdom (P.A.C., P.L., P.C., J.d.G.); Institute of Translational Medicine, University of Birmingham, United Kingdom (P.A.C., P.C.); Royal Infirmary of Edinburgh, Edinburgh, United Kingdeom (D.B.N.); Imperial College NHS Trust, London, United Kingdom (I.S.M.); Evelina Children's Hospital, London, United Kingdom (S.A.Q., G.M.); The Heart Hospital, London, United Kingdom (M.M.); Nottingham University Hospital, Nottingham, United Kingdom (R.H., H.R.K.); Bristol Heart Institute, Bristol, United Kingdom (M.T., Y.I.); University Hospital Coventry, Coventry, United Kingdom (M.B.); Mater Misericordiae University Hospital, Dublin, Ireland (K.P.W.); Mater Private Hospital, Dublin, Ireland (I.C.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (L.M., S.K.A.); Golden Jubilee National Hospital, Glasgow, United Kingdom (N.L.W.); Leeds General Infirmary, Leeds, United Kingdom (J.T.); Royal Victoria Hospital, Belfast, United Kingdom (M.S.S.); Manchester Royal Infirmary, Manchester, United Kingdom (V.S.M.); Castle Hill Hospital, Hull, United Kingdom (A.H.); King's College London, United Kingdom (P.A.M.); John Radcliffe Hospital, Oxford, United Kingdom (M.J.D., J.O.M.O., O.O.); and Royal Sussex County Hospital, Brighton, United Kingdom (S.S.C., D.H.-S.).
authors: John
authors: J
authors: Thomson
authors: From Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (P.A.C., L.S., W.R.D., B.S.R.); Queen Elizabeth Hospital, University Hospitals Birmingham, United Kingdom (P.A.C., P.L., P.C., J.d.G.); Institute of Translational Medicine, University of Birmingham, United Kingdom (P.A.C., P.C.); Royal Infirmary of Edinburgh, Edinburgh, United Kingdeom (D.B.N.); Imperial College NHS Trust, London, United Kingdom (I.S.M.); Evelina Children's Hospital, London, United Kingdom (S.A.Q., G.M.); The Heart Hospital, London, United Kingdom (M.M.); Nottingham University Hospital, Nottingham, United Kingdom (R.H., H.R.K.); Bristol Heart Institute, Bristol, United Kingdom (M.T., Y.I.); University Hospital Coventry, Coventry, United Kingdom (M.B.); Mater Misericordiae University Hospital, Dublin, Ireland (K.P.W.); Mater Private Hospital, Dublin, Ireland (I.C.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (L.M., S.K.A.); Golden Jubilee National Hospital, Glasgow, United Kingdom (N.L.W.); Leeds General Infirmary, Leeds, United Kingdom (J.T.); Royal Victoria Hospital, Belfast, United Kingdom (M.S.S.); Manchester Royal Infirmary, Manchester, United Kingdom (V.S.M.); Castle Hill Hospital, Hull, United Kingdom (A.H.); King's College London, United Kingdom (P.A.M.); John Radcliffe Hospital, Oxford, United Kingdom (M.J.D., J.O.M.O., O.O.); and Royal Sussex County Hospital, Brighton, United Kingdom (S.S.C., D.H.-S.).
authors: Mark S
authors: MS
authors: Spence
authors: From Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (P.A.C., L.S., W.R.D., B.S.R.); Queen Elizabeth Hospital, University Hospitals Birmingham, United Kingdom (P.A.C., P.L., P.C., J.d.G.); Institute of Translational Medicine, University of Birmingham, United Kingdom (P.A.C., P.C.); Royal Infirmary of Edinburgh, Edinburgh, United Kingdeom (D.B.N.); Imperial College NHS Trust, London, United Kingdom (I.S.M.); Evelina Children's Hospital, London, United Kingdom (S.A.Q., G.M.); The Heart Hospital, London, United Kingdom (M.M.); Nottingham University Hospital, Nottingham, United Kingdom (R.H., H.R.K.); Bristol Heart Institute, Bristol, United Kingdom (M.T., Y.I.); University Hospital Coventry, Coventry, United Kingdom (M.B.); Mater Misericordiae University Hospital, Dublin, Ireland (K.P.W.); Mater Private Hospital, Dublin, Ireland (I.C.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (L.M., S.K.A.); Golden Jubilee National Hospital, Glasgow, United Kingdom (N.L.W.); Leeds General Infirmary, Leeds, United Kingdom (J.T.); Royal Victoria Hospital, Belfast, United Kingdom (M.S.S.); Manchester Royal Infirmary, Manchester, United Kingdom (V.S.M.); Castle Hill Hospital, Hull, United Kingdom (A.H.); King's College London, United Kingdom (P.A.M.); John Radcliffe Hospital, Oxford, United Kingdom (M.J.D., J.O.M.O., O.O.); and Royal Sussex County Hospital, Brighton, United Kingdom (S.S.C., D.H.-S.).
authors: Vaikom S
authors: VS
authors: Mahadevan
authors: From Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (P.A.C., L.S., W.R.D., B.S.R.); Queen Elizabeth Hospital, University Hospitals Birmingham, United Kingdom (P.A.C., P.L., P.C., J.d.G.); Institute of Translational Medicine, University of Birmingham, United Kingdom (P.A.C., P.C.); Royal Infirmary of Edinburgh, Edinburgh, United Kingdeom (D.B.N.); Imperial College NHS Trust, London, United Kingdom (I.S.M.); Evelina Children's Hospital, London, United Kingdom (S.A.Q., G.M.); The Heart Hospital, London, United Kingdom (M.M.); Nottingham University Hospital, Nottingham, United Kingdom (R.H., H.R.K.); Bristol Heart Institute, Bristol, United Kingdom (M.T., Y.I.); University Hospital Coventry, Coventry, United Kingdom (M.B.); Mater Misericordiae University Hospital, Dublin, Ireland (K.P.W.); Mater Private Hospital, Dublin, Ireland (I.C.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (L.M., S.K.A.); Golden Jubilee National Hospital, Glasgow, United Kingdom (N.L.W.); Leeds General Infirmary, Leeds, United Kingdom (J.T.); Royal Victoria Hospital, Belfast, United Kingdom (M.S.S.); Manchester Royal Infirmary, Manchester, United Kingdom (V.S.M.); Castle Hill Hospital, Hull, United Kingdom (A.H.); King's College London, United Kingdom (P.A.M.); John Radcliffe Hospital, Oxford, United Kingdom (M.J.D., J.O.M.O., O.O.); and Royal Sussex County Hospital, Brighton, United Kingdom (S.S.C., D.H.-S.).
authors: Angela
authors: A
authors: Hoye
authors: From Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (P.A.C., L.S., W.R.D., B.S.R.); Queen Elizabeth Hospital, University Hospitals Birmingham, United Kingdom (P.A.C., P.L., P.C., J.d.G.); Institute of Translational Medicine, University of Birmingham, United Kingdom (P.A.C., P.C.); Royal Infirmary of Edinburgh, Edinburgh, United Kingdeom (D.B.N.); Imperial College NHS Trust, London, United Kingdom (I.S.M.); Evelina Children's Hospital, London, United Kingdom (S.A.Q., G.M.); The Heart Hospital, London, United Kingdom (M.M.); Nottingham University Hospital, Nottingham, United Kingdom (R.H., H.R.K.); Bristol Heart Institute, Bristol, United Kingdom (M.T., Y.I.); University Hospital Coventry, Coventry, United Kingdom (M.B.); Mater Misericordiae University Hospital, Dublin, Ireland (K.P.W.); Mater Private Hospital, Dublin, Ireland (I.C.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (L.M., S.K.A.); Golden Jubilee National Hospital, Glasgow, United Kingdom (N.L.W.); Leeds General Infirmary, Leeds, United Kingdom (J.T.); Royal Victoria Hospital, Belfast, United Kingdom (M.S.S.); Manchester Royal Infirmary, Manchester, United Kingdom (V.S.M.); Castle Hill Hospital, Hull, United Kingdom (A.H.); King's College London, United Kingdom (P.A.M.); John Radcliffe Hospital, Oxford, United Kingdom (M.J.D., J.O.M.O., O.O.); and Royal Sussex County Hospital, Brighton, United Kingdom (S.S.C., D.H.-S.).
authors: Philip A
authors: PA
authors: MacCarthy
authors: From Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (P.A.C., L.S., W.R.D., B.S.R.); Queen Elizabeth Hospital, University Hospitals Birmingham, United Kingdom (P.A.C., P.L., P.C., J.d.G.); Institute of Translational Medicine, University of Birmingham, United Kingdom (P.A.C., P.C.); Royal Infirmary of Edinburgh, Edinburgh, United Kingdeom (D.B.N.); Imperial College NHS Trust, London, United Kingdom (I.S.M.); Evelina Children's Hospital, London, United Kingdom (S.A.Q., G.M.); The Heart Hospital, London, United Kingdom (M.M.); Nottingham University Hospital, Nottingham, United Kingdom (R.H., H.R.K.); Bristol Heart Institute, Bristol, United Kingdom (M.T., Y.I.); University Hospital Coventry, Coventry, United Kingdom (M.B.); Mater Misericordiae University Hospital, Dublin, Ireland (K.P.W.); Mater Private Hospital, Dublin, Ireland (I.C.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (L.M., S.K.A.); Golden Jubilee National Hospital, Glasgow, United Kingdom (N.L.W.); Leeds General Infirmary, Leeds, United Kingdom (J.T.); Royal Victoria Hospital, Belfast, United Kingdom (M.S.S.); Manchester Royal Infirmary, Manchester, United Kingdom (V.S.M.); Castle Hill Hospital, Hull, United Kingdom (A.H.); King's College London, United Kingdom (P.A.M.); John Radcliffe Hospital, Oxford, United Kingdom (M.J.D., J.O.M.O., O.O.); and Royal Sussex County Hospital, Brighton, United Kingdom (S.S.C., D.H.-S.).
authors: Matthew J
authors: MJ
authors: Daniels
authors: From Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (P.A.C., L.S., W.R.D., B.S.R.); Queen Elizabeth Hospital, University Hospitals Birmingham, United Kingdom (P.A.C., P.L., P.C., J.d.G.); Institute of Translational Medicine, University of Birmingham, United Kingdom (P.A.C., P.C.); Royal Infirmary of Edinburgh, Edinburgh, United Kingdeom (D.B.N.); Imperial College NHS Trust, London, United Kingdom (I.S.M.); Evelina Children's Hospital, London, United Kingdom (S.A.Q., G.M.); The Heart Hospital, London, United Kingdom (M.M.); Nottingham University Hospital, Nottingham, United Kingdom (R.H., H.R.K.); Bristol Heart Institute, Bristol, United Kingdom (M.T., Y.I.); University Hospital Coventry, Coventry, United Kingdom (M.B.); Mater Misericordiae University Hospital, Dublin, Ireland (K.P.W.); Mater Private Hospital, Dublin, Ireland (I.C.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (L.M., S.K.A.); Golden Jubilee National Hospital, Glasgow, United Kingdom (N.L.W.); Leeds General Infirmary, Leeds, United Kingdom (J.T.); Royal Victoria Hospital, Belfast, United Kingdom (M.S.S.); Manchester Royal Infirmary, Manchester, United Kingdom (V.S.M.); Castle Hill Hospital, Hull, United Kingdom (A.H.); King's College London, United Kingdom (P.A.M.); John Radcliffe Hospital, Oxford, United Kingdom (M.J.D., J.O.M.O., O.O.); and Royal Sussex County Hospital, Brighton, United Kingdom (S.S.C., D.H.-S.).
authors: Paul
authors: P
authors: Clift
authors: From Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (P.A.C., L.S., W.R.D., B.S.R.); Queen Elizabeth Hospital, University Hospitals Birmingham, United Kingdom (P.A.C., P.L., P.C., J.d.G.); Institute of Translational Medicine, University of Birmingham, United Kingdom (P.A.C., P.C.); Royal Infirmary of Edinburgh, Edinburgh, United Kingdeom (D.B.N.); Imperial College NHS Trust, London, United Kingdom (I.S.M.); Evelina Children's Hospital, London, United Kingdom (S.A.Q., G.M.); The Heart Hospital, London, United Kingdom (M.M.); Nottingham University Hospital, Nottingham, United Kingdom (R.H., H.R.K.); Bristol Heart Institute, Bristol, United Kingdom (M.T., Y.I.); University Hospital Coventry, Coventry, United Kingdom (M.B.); Mater Misericordiae University Hospital, Dublin, Ireland (K.P.W.); Mater Private Hospital, Dublin, Ireland (I.C.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (L.M., S.K.A.); Golden Jubilee National Hospital, Glasgow, United Kingdom (N.L.W.); Leeds General Infirmary, Leeds, United Kingdom (J.T.); Royal Victoria Hospital, Belfast, United Kingdom (M.S.S.); Manchester Royal Infirmary, Manchester, United Kingdom (V.S.M.); Castle Hill Hospital, Hull, United Kingdom (A.H.); King's College London, United Kingdom (P.A.M.); John Radcliffe Hospital, Oxford, United Kingdom (M.J.D., J.O.M.O., O.O.); and Royal Sussex County Hospital, Brighton, United Kingdom (S.S.C., D.H.-S.).
authors: William R
authors: WR
authors: Davies
authors: From Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (P.A.C., L.S., W.R.D., B.S.R.); Queen Elizabeth Hospital, University Hospitals Birmingham, United Kingdom (P.A.C., P.L., P.C., J.d.G.); Institute of Translational Medicine, University of Birmingham, United Kingdom (P.A.C., P.C.); Royal Infirmary of Edinburgh, Edinburgh, United Kingdeom (D.B.N.); Imperial College NHS Trust, London, United Kingdom (I.S.M.); Evelina Children's Hospital, London, United Kingdom (S.A.Q., G.M.); The Heart Hospital, London, United Kingdom (M.M.); Nottingham University Hospital, Nottingham, United Kingdom (R.H., H.R.K.); Bristol Heart Institute, Bristol, United Kingdom (M.T., Y.I.); University Hospital Coventry, Coventry, United Kingdom (M.B.); Mater Misericordiae University Hospital, Dublin, Ireland (K.P.W.); Mater Private Hospital, Dublin, Ireland (I.C.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (L.M., S.K.A.); Golden Jubilee National Hospital, Glasgow, United Kingdom (N.L.W.); Leeds General Infirmary, Leeds, United Kingdom (J.T.); Royal Victoria Hospital, Belfast, United Kingdom (M.S.S.); Manchester Royal Infirmary, Manchester, United Kingdom (V.S.M.); Castle Hill Hospital, Hull, United Kingdom (A.H.); King's College London, United Kingdom (P.A.M.); John Radcliffe Hospital, Oxford, United Kingdom (M.J.D., J.O.M.O., O.O.); and Royal Sussex County Hospital, Brighton, United Kingdom (S.S.C., D.H.-S.).
authors: Philip D
authors: PD
authors: Adamson
authors: From Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (P.A.C., L.S., W.R.D., B.S.R.); Queen Elizabeth Hospital, University Hospitals Birmingham, United Kingdom (P.A.C., P.L., P.C., J.d.G.); Institute of Translational Medicine, University of Birmingham, United Kingdom (P.A.C., P.C.); Royal Infirmary of Edinburgh, Edinburgh, United Kingdeom (D.B.N.); Imperial College NHS Trust, London, United Kingdom (I.S.M.); Evelina Children's Hospital, London, United Kingdom (S.A.Q., G.M.); The Heart Hospital, London, United Kingdom (M.M.); Nottingham University Hospital, Nottingham, United Kingdom (R.H., H.R.K.); Bristol Heart Institute, Bristol, United Kingdom (M.T., Y.I.); University Hospital Coventry, Coventry, United Kingdom (M.B.); Mater Misericordiae University Hospital, Dublin, Ireland (K.P.W.); Mater Private Hospital, Dublin, Ireland (I.C.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (L.M., S.K.A.); Golden Jubilee National Hospital, Glasgow, United Kingdom (N.L.W.); Leeds General Infirmary, Leeds, United Kingdom (J.T.); Royal Victoria Hospital, Belfast, United Kingdom (M.S.S.); Manchester Royal Infirmary, Manchester, United Kingdom (V.S.M.); Castle Hill Hospital, Hull, United Kingdom (A.H.); King's College London, United Kingdom (P.A.M.); John Radcliffe Hospital, Oxford, United Kingdom (M.J.D., J.O.M.O., O.O.); and Royal Sussex County Hospital, Brighton, United Kingdom (S.S.C., D.H.-S.).
authors: Gareth
authors: G
authors: Morgan
authors: From Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (P.A.C., L.S., W.R.D., B.S.R.); Queen Elizabeth Hospital, University Hospitals Birmingham, United Kingdom (P.A.C., P.L., P.C., J.d.G.); Institute of Translational Medicine, University of Birmingham, United Kingdom (P.A.C., P.C.); Royal Infirmary of Edinburgh, Edinburgh, United Kingdeom (D.B.N.); Imperial College NHS Trust, London, United Kingdom (I.S.M.); Evelina Children's Hospital, London, United Kingdom (S.A.Q., G.M.); The Heart Hospital, London, United Kingdom (M.M.); Nottingham University Hospital, Nottingham, United Kingdom (R.H., H.R.K.); Bristol Heart Institute, Bristol, United Kingdom (M.T., Y.I.); University Hospital Coventry, Coventry, United Kingdom (M.B.); Mater Misericordiae University Hospital, Dublin, Ireland (K.P.W.); Mater Private Hospital, Dublin, Ireland (I.C.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (L.M., S.K.A.); Golden Jubilee National Hospital, Glasgow, United Kingdom (N.L.W.); Leeds General Infirmary, Leeds, United Kingdom (J.T.); Royal Victoria Hospital, Belfast, United Kingdom (M.S.S.); Manchester Royal Infirmary, Manchester, United Kingdom (V.S.M.); Castle Hill Hospital, Hull, United Kingdom (A.H.); King's College London, United Kingdom (P.A.M.); John Radcliffe Hospital, Oxford, United Kingdom (M.J.D., J.O.M.O., O.O.); and Royal Sussex County Hospital, Brighton, United Kingdom (S.S.C., D.H.-S.).
authors: Suneil K
authors: SK
authors: Aggarwal
authors: From Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (P.A.C., L.S., W.R.D., B.S.R.); Queen Elizabeth Hospital, University Hospitals Birmingham, United Kingdom (P.A.C., P.L., P.C., J.d.G.); Institute of Translational Medicine, University of Birmingham, United Kingdom (P.A.C., P.C.); Royal Infirmary of Edinburgh, Edinburgh, United Kingdeom (D.B.N.); Imperial College NHS Trust, London, United Kingdom (I.S.M.); Evelina Children's Hospital, London, United Kingdom (S.A.Q., G.M.); The Heart Hospital, London, United Kingdom (M.M.); Nottingham University Hospital, Nottingham, United Kingdom (R.H., H.R.K.); Bristol Heart Institute, Bristol, United Kingdom (M.T., Y.I.); University Hospital Coventry, Coventry, United Kingdom (M.B.); Mater Misericordiae University Hospital, Dublin, Ireland (K.P.W.); Mater Private Hospital, Dublin, Ireland (I.C.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (L.M., S.K.A.); Golden Jubilee National Hospital, Glasgow, United Kingdom (N.L.W.); Leeds General Infirmary, Leeds, United Kingdom (J.T.); Royal Victoria Hospital, Belfast, United Kingdom (M.S.S.); Manchester Royal Infirmary, Manchester, United Kingdom (V.S.M.); Castle Hill Hospital, Hull, United Kingdom (A.H.); King's College London, United Kingdom (P.A.M.); John Radcliffe Hospital, Oxford, United Kingdom (M.J.D., J.O.M.O., O.O.); and Royal Sussex County Hospital, Brighton, United Kingdom (S.S.C., D.H.-S.).
authors: Yasmin
authors: Y
authors: Ismail
authors: From Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (P.A.C., L.S., W.R.D., B.S.R.); Queen Elizabeth Hospital, University Hospitals Birmingham, United Kingdom (P.A.C., P.L., P.C., J.d.G.); Institute of Translational Medicine, University of Birmingham, United Kingdom (P.A.C., P.C.); Royal Infirmary of Edinburgh, Edinburgh, United Kingdeom (D.B.N.); Imperial College NHS Trust, London, United Kingdom (I.S.M.); Evelina Children's Hospital, London, United Kingdom (S.A.Q., G.M.); The Heart Hospital, London, United Kingdom (M.M.); Nottingham University Hospital, Nottingham, United Kingdom (R.H., H.R.K.); Bristol Heart Institute, Bristol, United Kingdom (M.T., Y.I.); University Hospital Coventry, Coventry, United Kingdom (M.B.); Mater Misericordiae University Hospital, Dublin, Ireland (K.P.W.); Mater Private Hospital, Dublin, Ireland (I.C.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (L.M., S.K.A.); Golden Jubilee National Hospital, Glasgow, United Kingdom (N.L.W.); Leeds General Infirmary, Leeds, United Kingdom (J.T.); Royal Victoria Hospital, Belfast, United Kingdom (M.S.S.); Manchester Royal Infirmary, Manchester, United Kingdom (V.S.M.); Castle Hill Hospital, Hull, United Kingdom (A.H.); King's College London, United Kingdom (P.A.M.); John Radcliffe Hospital, Oxford, United Kingdom (M.J.D., J.O.M.O., O.O.); and Royal Sussex County Hospital, Brighton, United Kingdom (S.S.C., D.H.-S.).
authors: Julian O M
authors: JO
authors: Ormerod
authors: From Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (P.A.C., L.S., W.R.D., B.S.R.); Queen Elizabeth Hospital, University Hospitals Birmingham, United Kingdom (P.A.C., P.L., P.C., J.d.G.); Institute of Translational Medicine, University of Birmingham, United Kingdom (P.A.C., P.C.); Royal Infirmary of Edinburgh, Edinburgh, United Kingdeom (D.B.N.); Imperial College NHS Trust, London, United Kingdom (I.S.M.); Evelina Children's Hospital, London, United Kingdom (S.A.Q., G.M.); The Heart Hospital, London, United Kingdom (M.M.); Nottingham University Hospital, Nottingham, United Kingdom (R.H., H.R.K.); Bristol Heart Institute, Bristol, United Kingdom (M.T., Y.I.); University Hospital Coventry, Coventry, United Kingdom (M.B.); Mater Misericordiae University Hospital, Dublin, Ireland (K.P.W.); Mater Private Hospital, Dublin, Ireland (I.C.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (L.M., S.K.A.); Golden Jubilee National Hospital, Glasgow, United Kingdom (N.L.W.); Leeds General Infirmary, Leeds, United Kingdom (J.T.); Royal Victoria Hospital, Belfast, United Kingdom (M.S.S.); Manchester Royal Infirmary, Manchester, United Kingdom (V.S.M.); Castle Hill Hospital, Hull, United Kingdom (A.H.); King's College London, United Kingdom (P.A.M.); John Radcliffe Hospital, Oxford, United Kingdom (M.J.D., J.O.M.O., O.O.); and Royal Sussex County Hospital, Brighton, United Kingdom (S.S.C., D.H.-S.).
authors: Habib R
authors: HR
authors: Khan
authors: From Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (P.A.C., L.S., W.R.D., B.S.R.); Queen Elizabeth Hospital, University Hospitals Birmingham, United Kingdom (P.A.C., P.L., P.C., J.d.G.); Institute of Translational Medicine, University of Birmingham, United Kingdom (P.A.C., P.C.); Royal Infirmary of Edinburgh, Edinburgh, United Kingdeom (D.B.N.); Imperial College NHS Trust, London, United Kingdom (I.S.M.); Evelina Children's Hospital, London, United Kingdom (S.A.Q., G.M.); The Heart Hospital, London, United Kingdom (M.M.); Nottingham University Hospital, Nottingham, United Kingdom (R.H., H.R.K.); Bristol Heart Institute, Bristol, United Kingdom (M.T., Y.I.); University Hospital Coventry, Coventry, United Kingdom (M.B.); Mater Misericordiae University Hospital, Dublin, Ireland (K.P.W.); Mater Private Hospital, Dublin, Ireland (I.C.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (L.M., S.K.A.); Golden Jubilee National Hospital, Glasgow, United Kingdom (N.L.W.); Leeds General Infirmary, Leeds, United Kingdom (J.T.); Royal Victoria Hospital, Belfast, United Kingdom (M.S.S.); Manchester Royal Infirmary, Manchester, United Kingdom (V.S.M.); Castle Hill Hospital, Hull, United Kingdom (A.H.); King's College London, United Kingdom (P.A.M.); John Radcliffe Hospital, Oxford, United Kingdom (M.J.D., J.O.M.O., O.O.); and Royal Sussex County Hospital, Brighton, United Kingdom (S.S.C., D.H.-S.).
authors: Sujay Subash
authors: SS
authors: Chandran
authors: From Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (P.A.C., L.S., W.R.D., B.S.R.); Queen Elizabeth Hospital, University Hospitals Birmingham, United Kingdom (P.A.C., P.L., P.C., J.d.G.); Institute of Translational Medicine, University of Birmingham, United Kingdom (P.A.C., P.C.); Royal Infirmary of Edinburgh, Edinburgh, United Kingdeom (D.B.N.); Imperial College NHS Trust, London, United Kingdom (I.S.M.); Evelina Children's Hospital, London, United Kingdom (S.A.Q., G.M.); The Heart Hospital, London, United Kingdom (M.M.); Nottingham University Hospital, Nottingham, United Kingdom (R.H., H.R.K.); Bristol Heart Institute, Bristol, United Kingdom (M.T., Y.I.); University Hospital Coventry, Coventry, United Kingdom (M.B.); Mater Misericordiae University Hospital, Dublin, Ireland (K.P.W.); Mater Private Hospital, Dublin, Ireland (I.C.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (L.M., S.K.A.); Golden Jubilee National Hospital, Glasgow, United Kingdom (N.L.W.); Leeds General Infirmary, Leeds, United Kingdom (J.T.); Royal Victoria Hospital, Belfast, United Kingdom (M.S.S.); Manchester Royal Infirmary, Manchester, United Kingdom (V.S.M.); Castle Hill Hospital, Hull, United Kingdom (A.H.); King's College London, United Kingdom (P.A.M.); John Radcliffe Hospital, Oxford, United Kingdom (M.J.D., J.O.M.O., O.O.); and Royal Sussex County Hospital, Brighton, United Kingdom (S.S.C., D.H.-S.).
authors: Joseph
authors: J
authors: de Giovanni
authors: From Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (P.A.C., L.S., W.R.D., B.S.R.); Queen Elizabeth Hospital, University Hospitals Birmingham, United Kingdom (P.A.C., P.L., P.C., J.d.G.); Institute of Translational Medicine, University of Birmingham, United Kingdom (P.A.C., P.C.); Royal Infirmary of Edinburgh, Edinburgh, United Kingdeom (D.B.N.); Imperial College NHS Trust, London, United Kingdom (I.S.M.); Evelina Children's Hospital, London, United Kingdom (S.A.Q., G.M.); The Heart Hospital, London, United Kingdom (M.M.); Nottingham University Hospital, Nottingham, United Kingdom (R.H., H.R.K.); Bristol Heart Institute, Bristol, United Kingdom (M.T., Y.I.); University Hospital Coventry, Coventry, United Kingdom (M.B.); Mater Misericordiae University Hospital, Dublin, Ireland (K.P.W.); Mater Private Hospital, Dublin, Ireland (I.C.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (L.M., S.K.A.); Golden Jubilee National Hospital, Glasgow, United Kingdom (N.L.W.); Leeds General Infirmary, Leeds, United Kingdom (J.T.); Royal Victoria Hospital, Belfast, United Kingdom (M.S.S.); Manchester Royal Infirmary, Manchester, United Kingdom (V.S.M.); Castle Hill Hospital, Hull, United Kingdom (A.H.); King's College London, United Kingdom (P.A.M.); John Radcliffe Hospital, Oxford, United Kingdom (M.J.D., J.O.M.O., O.O.); and Royal Sussex County Hospital, Brighton, United Kingdom (S.S.C., D.H.-S.).
authors: Bushra S
authors: BS
authors: Rana
authors: From Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (P.A.C., L.S., W.R.D., B.S.R.); Queen Elizabeth Hospital, University Hospitals Birmingham, United Kingdom (P.A.C., P.L., P.C., J.d.G.); Institute of Translational Medicine, University of Birmingham, United Kingdom (P.A.C., P.C.); Royal Infirmary of Edinburgh, Edinburgh, United Kingdeom (D.B.N.); Imperial College NHS Trust, London, United Kingdom (I.S.M.); Evelina Children's Hospital, London, United Kingdom (S.A.Q., G.M.); The Heart Hospital, London, United Kingdom (M.M.); Nottingham University Hospital, Nottingham, United Kingdom (R.H., H.R.K.); Bristol Heart Institute, Bristol, United Kingdom (M.T., Y.I.); University Hospital Coventry, Coventry, United Kingdom (M.B.); Mater Misericordiae University Hospital, Dublin, Ireland (K.P.W.); Mater Private Hospital, Dublin, Ireland (I.C.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (L.M., S.K.A.); Golden Jubilee National Hospital, Glasgow, United Kingdom (N.L.W.); Leeds General Infirmary, Leeds, United Kingdom (J.T.); Royal Victoria Hospital, Belfast, United Kingdom (M.S.S.); Manchester Royal Infirmary, Manchester, United Kingdom (V.S.M.); Castle Hill Hospital, Hull, United Kingdom (A.H.); King's College London, United Kingdom (P.A.M.); John Radcliffe Hospital, Oxford, United Kingdom (M.J.D., J.O.M.O., O.O.); and Royal Sussex County Hospital, Brighton, United Kingdom (S.S.C., D.H.-S.).
authors: Oliver
authors: O
authors: Ormerod
authors: From Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (P.A.C., L.S., W.R.D., B.S.R.); Queen Elizabeth Hospital, University Hospitals Birmingham, United Kingdom (P.A.C., P.L., P.C., J.d.G.); Institute of Translational Medicine, University of Birmingham, United Kingdom (P.A.C., P.C.); Royal Infirmary of Edinburgh, Edinburgh, United Kingdeom (D.B.N.); Imperial College NHS Trust, London, United Kingdom (I.S.M.); Evelina Children's Hospital, London, United Kingdom (S.A.Q., G.M.); The Heart Hospital, London, United Kingdom (M.M.); Nottingham University Hospital, Nottingham, United Kingdom (R.H., H.R.K.); Bristol Heart Institute, Bristol, United Kingdom (M.T., Y.I.); University Hospital Coventry, Coventry, United Kingdom (M.B.); Mater Misericordiae University Hospital, Dublin, Ireland (K.P.W.); Mater Private Hospital, Dublin, Ireland (I.C.); Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (L.M., S.K.A.); Golden Jubilee National Hospital, Glasgow, United Kingdom (N.L.W.); Leeds General Infirmary, Leeds, United Kingdom (J.T.); Royal Victoria Hospital, Belfast, United Kingdom (M.S.S.); Manchester Royal Infirmary, Manchester, United Kingdom (V.S.M.); Castle Hill Hospital, Hull, United Kingdom (A.H.); King's College London, United Kingdom (P.A.M.); John Radcliffe Hospital, Oxford, United Kingdom (M.J.D., J.O.M.O., O.O.); and Royal Sussex County Hospital, Brighton, United Kingdom (S.S.C., D.H.-S.).
authors: David
authors: D
authors: Hildick-Smith
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization / Q000379:methods; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology*; D011475:Prosthesis Failure / Q000009:adverse effects*; D012086:Reoperation / Q000379:methods; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods; D006113:United Kingdom
keywords: catheters; heart failure; paravalvular regurgitation; survival