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Percutaneous Mitral and Aortic Paravalvular Leak Repair: Indications, Current Application, and Future Directions

  • Valvular Heart Disease (V Nkomo, Section Editor)
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Abstract

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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Acknowledgments

Dr. Binder received an unrestricted research grant from the Swiss National Foundation.

Disclosure

Conflicts of interest: R.K. Binder: none; J.G. Webb: has been a consultant for St. Jude Medical.

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Authors and Affiliations

  1. St. Paul’s Hospital, University of British Columbia, 1081 Burrard Street, V6Z 1Y6, Vancouver, BC, Canada

    Ronald K. Binder & John G. Webb

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  1. Ronald K. Binder
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  2. John G. Webb
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Correspondence to John G. Webb.

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This article is part of the Topical Collection on Valvular Heart Disease

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Binder, R.K., Webb, J.G. Percutaneous Mitral and Aortic Paravalvular Leak Repair: Indications, Current Application, and Future Directions. Curr Cardiol Rep 15, 342 (2013). https://doi.org/10.1007/s11886-012-0342-2

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  • DOI: https://doi.org/10.1007/s11886-012-0342-2

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