Journal
CURRENT CARDIOLOGY REPORTS
Volume 15, Issue 3, Pages -Publisher
SPRINGER
DOI: 10.1007/s11886-012-0342-2
Keywords
Perivalvular leak; Percutaneous intervention; Aortic valve replacement; Paravalvular regurgitation; Mitral valve replacement; Surgical bioprosthesis; Mechanical valve prosthesis
Categories
Funding
- Swiss National Foundation
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Paravalvular regurgitation (PVR) is a symptomatic or asymptomatic complication after surgical valve replacement. It may be related to calcification, infection or tissue friability and occurs in 5 % to 17 % of surgical implanted heart valves. Reoperation is associated with a higher morbidity and mortality than the index procedure. Percutaneous closure of PVR can be an effective and lower risk alternative to reoperation. However, feasibility for percutaneous closure has to be assessed by defining the shape, size and location of the defect. Echocardiography with three-dimensional defect reconstruction is a cornerstone for guiding percutaneous PVR closure. Access for aortic PVR is usually retrograde via the femoral artery and access to mitral PVR either retrograde from the aorta, transvenous-transseptal or transapical. Meticulous planning and prudent procedural execution by experienced operators ensuring no impingement of the prosthetic leaflets leads to a high success rate of percutaneous PVR repair.
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