Long-term follow-up of percutaneous repair of paravalvular prosthetic regurgitation

Paul Sorajja, Allison K. Cabalka, Donald J. Hagler, Charanjit S. Rihal

Research output: Contribution to journalArticle

135 Citations (Scopus)

Abstract

Objectives: The goal of this study was to determine the long-term clinical efficacy of percutaneous repair of paravalvular prosthetic regurgitation. Background: Percutaneous repair has emerged as an effective therapy for patients with paravalvular prosthetic regurgitation. Methods: We retrospectively identified 126 patients who underwent catheter-based treatment of symptomatic prosthetic paravalvular regurgitation. Patients were contacted for symptoms, clinical events, and vital status. Results: The 3-year estimate for survival was 64.3% (95% confidence interval: 52.1% to 76.8%). Mortality occurred due to cardiac, noncardiac, and unknown causes in 9.5%, 7.1%, and 5.6% of patients, respectively. Among survivors, 72% of patients who had presented with heart failure were free of severe symptoms and need for cardiac surgery. Severity of residual regurgitation was not related to overall survival but was an important determinant of other clinical events. For those with no, mild, or moderate or severe residual regurgitation, 3-year estimate of survival free of death or need for surgery was 63.3%, 58.3%, and 30.3% (p = 0.01), respectively. Conclusions: Percutaneous repair of paravalvular prosthetic regurgitation can lead to durable symptom relief in selected patients. Nonetheless, mortality remains significant in symptomatic patients with paravalvular prosthetic regurgitation. Long-term clinical efficacy is highly dependent on residual regurgitation.

Original languageEnglish (US)
Pages (from-to)2218-2224
Number of pages7
JournalJournal of the American College of Cardiology
Volume58
Issue number21
DOIs
StatePublished - Nov 15 2011

Fingerprint

Survival
Mortality
Thoracic Surgery
Survivors
Catheters
Heart Failure
Confidence Intervals
Therapeutics

Keywords

  • percutaneous repair
  • prosthesis
  • regurgitation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Long-term follow-up of percutaneous repair of paravalvular prosthetic regurgitation. / Sorajja, Paul; Cabalka, Allison K.; Hagler, Donald J.; Rihal, Charanjit S.

In: Journal of the American College of Cardiology, Vol. 58, No. 21, 15.11.2011, p. 2218-2224.

Research output: Contribution to journalArticle

Sorajja, Paul ; Cabalka, Allison K. ; Hagler, Donald J. ; Rihal, Charanjit S. / Long-term follow-up of percutaneous repair of paravalvular prosthetic regurgitation. In: Journal of the American College of Cardiology. 2011 ; Vol. 58, No. 21. pp. 2218-2224.
@article{681c9dcda3034b95a1659317bbd1393b,
title = "Long-term follow-up of percutaneous repair of paravalvular prosthetic regurgitation",
abstract = "Objectives: The goal of this study was to determine the long-term clinical efficacy of percutaneous repair of paravalvular prosthetic regurgitation. Background: Percutaneous repair has emerged as an effective therapy for patients with paravalvular prosthetic regurgitation. Methods: We retrospectively identified 126 patients who underwent catheter-based treatment of symptomatic prosthetic paravalvular regurgitation. Patients were contacted for symptoms, clinical events, and vital status. Results: The 3-year estimate for survival was 64.3{\%} (95{\%} confidence interval: 52.1{\%} to 76.8{\%}). Mortality occurred due to cardiac, noncardiac, and unknown causes in 9.5{\%}, 7.1{\%}, and 5.6{\%} of patients, respectively. Among survivors, 72{\%} of patients who had presented with heart failure were free of severe symptoms and need for cardiac surgery. Severity of residual regurgitation was not related to overall survival but was an important determinant of other clinical events. For those with no, mild, or moderate or severe residual regurgitation, 3-year estimate of survival free of death or need for surgery was 63.3{\%}, 58.3{\%}, and 30.3{\%} (p = 0.01), respectively. Conclusions: Percutaneous repair of paravalvular prosthetic regurgitation can lead to durable symptom relief in selected patients. Nonetheless, mortality remains significant in symptomatic patients with paravalvular prosthetic regurgitation. Long-term clinical efficacy is highly dependent on residual regurgitation.",
keywords = "percutaneous repair, prosthesis, regurgitation",
author = "Paul Sorajja and Cabalka, {Allison K.} and Hagler, {Donald J.} and Rihal, {Charanjit S.}",
year = "2011",
month = "11",
day = "15",
doi = "10.1016/j.jacc.2011.07.041",
language = "English (US)",
volume = "58",
pages = "2218--2224",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "21",

}

TY - JOUR

T1 - Long-term follow-up of percutaneous repair of paravalvular prosthetic regurgitation

AU - Sorajja, Paul

AU - Cabalka, Allison K.

AU - Hagler, Donald J.

AU - Rihal, Charanjit S.

PY - 2011/11/15

Y1 - 2011/11/15

N2 - Objectives: The goal of this study was to determine the long-term clinical efficacy of percutaneous repair of paravalvular prosthetic regurgitation. Background: Percutaneous repair has emerged as an effective therapy for patients with paravalvular prosthetic regurgitation. Methods: We retrospectively identified 126 patients who underwent catheter-based treatment of symptomatic prosthetic paravalvular regurgitation. Patients were contacted for symptoms, clinical events, and vital status. Results: The 3-year estimate for survival was 64.3% (95% confidence interval: 52.1% to 76.8%). Mortality occurred due to cardiac, noncardiac, and unknown causes in 9.5%, 7.1%, and 5.6% of patients, respectively. Among survivors, 72% of patients who had presented with heart failure were free of severe symptoms and need for cardiac surgery. Severity of residual regurgitation was not related to overall survival but was an important determinant of other clinical events. For those with no, mild, or moderate or severe residual regurgitation, 3-year estimate of survival free of death or need for surgery was 63.3%, 58.3%, and 30.3% (p = 0.01), respectively. Conclusions: Percutaneous repair of paravalvular prosthetic regurgitation can lead to durable symptom relief in selected patients. Nonetheless, mortality remains significant in symptomatic patients with paravalvular prosthetic regurgitation. Long-term clinical efficacy is highly dependent on residual regurgitation.

AB - Objectives: The goal of this study was to determine the long-term clinical efficacy of percutaneous repair of paravalvular prosthetic regurgitation. Background: Percutaneous repair has emerged as an effective therapy for patients with paravalvular prosthetic regurgitation. Methods: We retrospectively identified 126 patients who underwent catheter-based treatment of symptomatic prosthetic paravalvular regurgitation. Patients were contacted for symptoms, clinical events, and vital status. Results: The 3-year estimate for survival was 64.3% (95% confidence interval: 52.1% to 76.8%). Mortality occurred due to cardiac, noncardiac, and unknown causes in 9.5%, 7.1%, and 5.6% of patients, respectively. Among survivors, 72% of patients who had presented with heart failure were free of severe symptoms and need for cardiac surgery. Severity of residual regurgitation was not related to overall survival but was an important determinant of other clinical events. For those with no, mild, or moderate or severe residual regurgitation, 3-year estimate of survival free of death or need for surgery was 63.3%, 58.3%, and 30.3% (p = 0.01), respectively. Conclusions: Percutaneous repair of paravalvular prosthetic regurgitation can lead to durable symptom relief in selected patients. Nonetheless, mortality remains significant in symptomatic patients with paravalvular prosthetic regurgitation. Long-term clinical efficacy is highly dependent on residual regurgitation.

KW - percutaneous repair

KW - prosthesis

KW - regurgitation

UR - http://www.scopus.com/inward/record.url?scp=80855128795&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80855128795&partnerID=8YFLogxK

U2 - 10.1016/j.jacc.2011.07.041

DO - 10.1016/j.jacc.2011.07.041

M3 - Article

C2 - 22078428

AN - SCOPUS:80855128795

VL - 58

SP - 2218

EP - 2224

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 21

ER -