Techniques and outcomes of paravalvular leak repair after transcatheter aortic valve replacement

Thomas M. Waterbury, Guy S. Reeder, Sorin V. Pislaru, Allison K. Cabalka, Charanjit Rihal, Mackram Eleid

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objectives: To investigate the feasibility, procedural success, and outcomes of paravalvular leak (PVL) closure in patients with prior transcatheter aortic valve replacement (TAVR). Background: PVL after TAVR is associated with adverse patient outcomes and increased mortality. Percutaneous PVL closure has emerged as a therapeutic strategy for addressing this issue, but data for transcatheter PVL repair after TAVR remains limited. Methods: This is a single center retrospective review of PVL closure after TAVR. Patients with balloon-expandable or self-expanding prostheses were included. Baseline patient demographics, procedural characteristics, complications, and clinical outcomes were reviewed. Results: A total of 18 patients with clinically significant PVL after TAVR referred for PVL closure were identified during the study period. Procedural success resulting in successful transcatheter occluder plug delivery was 78% (14 cases). Balloon postdilatation (2/4) and valve-in-valve (2/4) were used effectively in the remaining patients after an unsuccessful PVL closure attempt. PVL grading by echocardiography decreased from moderate or severe to<moderate in 13 patients (72%). Adverse events including cardiac tamponade and acute kidney injury occurred in 1 case each. One-month all-cause mortality was 11%. Conclusion: In selected patients, percutaneous PVL repair following TAVR is feasible and effective for both balloon-expandable and self-expanding prostheses. Most patients undergoing PVL closure after TAVR require a single occluder plug placement for reduction in PVL to mild or less.

Original languageEnglish (US)
JournalCatheterization and Cardiovascular Interventions
DOIs
StateAccepted/In press - 2017

Fingerprint

Prostheses and Implants
Transcatheter Aortic Valve Replacement
Cardiac Tamponade
Mortality
Acute Kidney Injury
Echocardiography
Demography
Therapeutics

Keywords

  • Aortic valve disease
  • Paravalvular leak
  • Structural heart disease intervention

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Techniques and outcomes of paravalvular leak repair after transcatheter aortic valve replacement. / Waterbury, Thomas M.; Reeder, Guy S.; Pislaru, Sorin V.; Cabalka, Allison K.; Rihal, Charanjit; Eleid, Mackram.

In: Catheterization and Cardiovascular Interventions, 2017.

Research output: Contribution to journalArticle

Waterbury, Thomas M. ; Reeder, Guy S. ; Pislaru, Sorin V. ; Cabalka, Allison K. ; Rihal, Charanjit ; Eleid, Mackram. / Techniques and outcomes of paravalvular leak repair after transcatheter aortic valve replacement. In: Catheterization and Cardiovascular Interventions. 2017.
@article{b940415b88f94309bcdd03abc30b2f58,
title = "Techniques and outcomes of paravalvular leak repair after transcatheter aortic valve replacement",
abstract = "Objectives: To investigate the feasibility, procedural success, and outcomes of paravalvular leak (PVL) closure in patients with prior transcatheter aortic valve replacement (TAVR). Background: PVL after TAVR is associated with adverse patient outcomes and increased mortality. Percutaneous PVL closure has emerged as a therapeutic strategy for addressing this issue, but data for transcatheter PVL repair after TAVR remains limited. Methods: This is a single center retrospective review of PVL closure after TAVR. Patients with balloon-expandable or self-expanding prostheses were included. Baseline patient demographics, procedural characteristics, complications, and clinical outcomes were reviewed. Results: A total of 18 patients with clinically significant PVL after TAVR referred for PVL closure were identified during the study period. Procedural success resulting in successful transcatheter occluder plug delivery was 78{\%} (14 cases). Balloon postdilatation (2/4) and valve-in-valve (2/4) were used effectively in the remaining patients after an unsuccessful PVL closure attempt. PVL grading by echocardiography decreased from moderate or severe to",
keywords = "Aortic valve disease, Paravalvular leak, Structural heart disease intervention",
author = "Waterbury, {Thomas M.} and Reeder, {Guy S.} and Pislaru, {Sorin V.} and Cabalka, {Allison K.} and Charanjit Rihal and Mackram Eleid",
year = "2017",
doi = "10.1002/ccd.27224",
language = "English (US)",
journal = "Catheterization and Cardiovascular Interventions",
issn = "1522-1946",
publisher = "Wiley-Liss Inc.",

}

TY - JOUR

T1 - Techniques and outcomes of paravalvular leak repair after transcatheter aortic valve replacement

AU - Waterbury, Thomas M.

AU - Reeder, Guy S.

AU - Pislaru, Sorin V.

AU - Cabalka, Allison K.

AU - Rihal, Charanjit

AU - Eleid, Mackram

PY - 2017

Y1 - 2017

N2 - Objectives: To investigate the feasibility, procedural success, and outcomes of paravalvular leak (PVL) closure in patients with prior transcatheter aortic valve replacement (TAVR). Background: PVL after TAVR is associated with adverse patient outcomes and increased mortality. Percutaneous PVL closure has emerged as a therapeutic strategy for addressing this issue, but data for transcatheter PVL repair after TAVR remains limited. Methods: This is a single center retrospective review of PVL closure after TAVR. Patients with balloon-expandable or self-expanding prostheses were included. Baseline patient demographics, procedural characteristics, complications, and clinical outcomes were reviewed. Results: A total of 18 patients with clinically significant PVL after TAVR referred for PVL closure were identified during the study period. Procedural success resulting in successful transcatheter occluder plug delivery was 78% (14 cases). Balloon postdilatation (2/4) and valve-in-valve (2/4) were used effectively in the remaining patients after an unsuccessful PVL closure attempt. PVL grading by echocardiography decreased from moderate or severe to

AB - Objectives: To investigate the feasibility, procedural success, and outcomes of paravalvular leak (PVL) closure in patients with prior transcatheter aortic valve replacement (TAVR). Background: PVL after TAVR is associated with adverse patient outcomes and increased mortality. Percutaneous PVL closure has emerged as a therapeutic strategy for addressing this issue, but data for transcatheter PVL repair after TAVR remains limited. Methods: This is a single center retrospective review of PVL closure after TAVR. Patients with balloon-expandable or self-expanding prostheses were included. Baseline patient demographics, procedural characteristics, complications, and clinical outcomes were reviewed. Results: A total of 18 patients with clinically significant PVL after TAVR referred for PVL closure were identified during the study period. Procedural success resulting in successful transcatheter occluder plug delivery was 78% (14 cases). Balloon postdilatation (2/4) and valve-in-valve (2/4) were used effectively in the remaining patients after an unsuccessful PVL closure attempt. PVL grading by echocardiography decreased from moderate or severe to

KW - Aortic valve disease

KW - Paravalvular leak

KW - Structural heart disease intervention

UR - http://www.scopus.com/inward/record.url?scp=85026650120&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85026650120&partnerID=8YFLogxK

U2 - 10.1002/ccd.27224

DO - 10.1002/ccd.27224

M3 - Article

C2 - 28766839

AN - SCOPUS:85026650120

JO - Catheterization and Cardiovascular Interventions

JF - Catheterization and Cardiovascular Interventions

SN - 1522-1946

ER -