Skip to main content

Repair of Paravalvular Leaks

  • Chapter
  • First Online:
  • 963 Accesses

Abstract

Paravalvular leak (PVL) remains an important complication of surgically placed prosthetic valves. Treatment options historically have been limited to redo surgery, which is associated with a relatively high mortality and the need for repeat surgeries. Percutaneous techniques offer a less invasive yet highly successful alternative to surgery. We describe incidence, clinical presentation, and percutaneous approaches to repair of paravalvular leak with an Amplatzer device.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Rihal CS, Sorajja P, Booker JD, Hagler DJ, Cabalka AK. Principles of percutaneous paravalvular leak closure. JACC Cardiovasc Interv. 2012;5(2):121–30.

    Article  PubMed  Google Scholar 

  2. Rallidis LS, Moyssakis IE, Ikonomidis I, Nihoyannopoulos P. Natural history of early aortic paraprosthetic regurgitation: a five-year follow-up. Am Heart J. 1999;138(2 Pt 1):351–7.

    Article  CAS  PubMed  Google Scholar 

  3. Dávila-Román VG, Waggoner AD, Kennard ED, Holubkov R, Jamieson WR, Englberger L, Carrel TP, Schaff HV, Artificial Valve Endocarditis Reduction Trial Echocardiography Study. Prevalence and severity of paravalvular regurgitation in the Artificial Valve Endocarditis Reduction Trial (AVERT) echocardiography study. J Am Coll Cardiol. 2004;44(7):1467–72.

    Article  PubMed  Google Scholar 

  4. Schaff HV, Carrel TP, Jamieson WR, Jones KW, Rufilanchas JJ, Cooley DA, Hetzer R, Stumpe F, Duveau D, Moseley P, van Boven WJ, Grunkemeier GL, Kennard ED, Holubkov R, Artificial Valve Endocarditis Reduction Trial. Paravalvular leak and other events in silzone-coated mechanical heart valves: a report from AVERT. Ann Thorac Surg. 2002;73(3):785–92.

    Article  PubMed  Google Scholar 

  5. Komoda T, Hetzer R, Siniawski H, Oellinger J, Felix R, Uyama C, Maeta H. Effects of prosthetic valve placement on mitral annular dynamics and the left ventricular base. ASAIO J. 2001;47(1):60–5.

    Article  CAS  PubMed  Google Scholar 

  6. Pate GE, Al Zubaidi A, Chandavimol M, Thompson CR, Munt BI, Webb JG. Percutaneous closure of prosthetic paravalvular leaks: case series and review. Catheter Cardiovasc Interv. 2006;68(4):528–33.

    Article  PubMed  Google Scholar 

  7. Leontyev S, Borger MA, Davierwala P, Walther T, Lehmann S, Kempfert J, Mohr FW. Redo aortic valve surgery: early and late outcomes. Ann Thorac Surg. 2011;91(4):1120–6.

    Article  PubMed  Google Scholar 

  8. Maganti M, Rao V, Armstrong S, Feindel CM, Scully HE, David TE. Redo valvular surgery in elderly patients. Ann Thorac Surg. 2009;87(2):521–5.

    Article  PubMed  Google Scholar 

  9. Sampath Kumar A, Dhareshwar J, Airan B, Bhan A, Sharma R, Venugopal P. Redo mitral valve surgery-a long-term experience. J Card Surg. 2004;19(4):303–7.

    Article  PubMed  Google Scholar 

  10. Lock J. Catheter closure of paravalvular leaks. In: Fourth international workshop in catheter interventions in congenital heart disease, Frankfurt, Germany; 2001.

    Google Scholar 

  11. Choi JW, Hwang HY, Kim KH, Kim KB, Ahn H. Long-term results of surgical correction for mitral paravalvular leak: repair versus re-replacement. J Heart Valve Dis. 2013;22(5):682–7.

    PubMed  Google Scholar 

  12. Erez E, Tam VK, Williams WH, Kanter KR. The Konno aortoventriculoplasty for repeat aortic valve replacement. Eur J Cardiothorac Surg. 2001;19(6):793–6.

    Article  CAS  PubMed  Google Scholar 

  13. O’Rourke DJ, Palac RT, Malenka DJ, Marrin CA, Arbuckle BE, Plehn JF. Outcome of mild periprosthetic regurgitation detected by intraoperative transesophageal echocardiography. J Am Coll Cardiol. 2001;38(1):163–6.

    Article  PubMed  Google Scholar 

  14. Sorajja P, Cabalka AK, Hagler DJ, Rihal CS. The learning curve in percutaneous repair of paravalvular prosthetic regurgitation: an analysis of 200 cases. JACC Cardiovasc Interv. 2014;7(5):521–9.

    Article  PubMed  Google Scholar 

  15. Ruiz CE, Jelnin V, Kronzon I, Dudiy Y, Del Valle-Fernandez R, Einhorn BN, Chiam PT, Martinez C, Eiros R, Roubin G, Cohen HA. Clinical outcomes in patients undergoing percutaneous closure of periprosthetic paravalvular leaks. J Am Coll Cardiol. 2011;58(21):2210–7.

    Article  PubMed  Google Scholar 

  16. Taramasso M, Maisano F, Latib A, Denti P, Guidotti A, Sticchi A, Panoulas V, Giustino G, Pozzoli A, Buzzatti N, Cota L, De Bonis M, Montorfano M, Castiglioni A, Blasio A, La Canna G, Colombo A, Alfieri O. Conventional surgery and transcatheter closure via surgical transapical approach for paravalvular leak repair in high-risk patients: results from a single-centre experience. Eur Heart J Cardiovasc Imaging. 2014;5(10):1161–7.

    Article  Google Scholar 

  17. Nietlispach F, Johnson M, Moss RR, Wijesinghe N, Gurvitch R, Tay EL, Thompson C, Webb JG. Transcatheter closure of paravalvular defects using a purpose-specific occluder. JACC Cardiovasc Interv. 2010;3(7):759–65.

    Article  PubMed  Google Scholar 

  18. De Cicco G, Russo C, Moreo A, Beghi C, Fucci C, Gerometta P, Lorusso R. Mitral valve periprosthetic leakage: anatomical observations in 135 patients from a multicentre study. Eur J Cardiothorac Surg. 2006;30(6):887–91.

    Article  PubMed  Google Scholar 

  19. Kim MS, Casserly IP, Garcia JA, Klein AJ, Salcedo EE, Carroll JD. Percutaneous transcatheter closure of prosthetic mitral paravalvular leaks: are we there yet? JACC Cardiovasc Interv. 2009;2(2):81–90.

    Article  PubMed  Google Scholar 

  20. García E, Sandoval J, Unzue L, Hernandez-Antolin R, Almería C, Macaya C. Paravalvular leaks: mechanisms, diagnosis and management. EuroIntervention. 2012;8(Suppl Q):Q41–52.

    Article  PubMed  Google Scholar 

  21. Alam M, Serwin JB, Rosman HS, Polanco GA, Sun I, Silverman NA. Transesophageal echocardiographic features of normal and dysfunctioning bioprosthetic valves. Am Heart J. 1991;121(4 Pt 1):1149–55.

    Article  CAS  PubMed  Google Scholar 

  22. Marx GR, Su X. Three-dimensional echocardiography in congenital heart disease. Cardiol Clin. 2007;25(2):357–65.

    Article  PubMed  Google Scholar 

  23. Ommen SR, Higano ST, Nishimura RA, Holmes Jr DR. Summary of the Mayo Clinic experience with direct left ventricular puncture. Cathet Cardiovasc Diagn. 1998;44(2):175–8.

    Article  CAS  PubMed  Google Scholar 

  24. Jelnin V, Dudiy Y, Einhorn BN, Kronzon I, Cohen HA, Ruiz CE. Clinical experience with percutaneous left ventricular transapical access for interventions in structural heart defects a safe access and secure exit. JACC Cardiovasc Interv. 2011;4(8):868–74. doi:10.1016/j.jcin.2011.05.018.

    Article  PubMed  Google Scholar 

  25. Peuster M, Boekenkamp R, Kaulitz R, Fink C, Hausdorf G. Transcatheter retrieval and repositioning of an Amplatzer device embolized into the left atrium. Catheter Cardiovasc Interv. 2000;51(3):297–300.

    Article  CAS  PubMed  Google Scholar 

  26. Levi DS, Moore JW. Embolization and retrieval of the Amplatzer septal occluder. Catheter Cardiovasc Interv. 2004;61(4):543–7.

    Article  PubMed  Google Scholar 

  27. Shirodkar S, Patil S, Pinto R, Dalvi B. Successful retrieval of migrated Amplatzer septal occluder. Ann Pediatr Cardiol. 2010;3(1):83–6.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Chan KT, Cheng BC. Retrieval of an embolized amplatzer septal occluder. Catheter Cardiovasc Interv. 2010;75(3):465–8.

    PubMed  Google Scholar 

  29. Goel PK, Kapoor A, Batra A, Khanna R. Transcatheter retrieval of embolized Amplatzer Septal Occluder. Tex Heart Inst J. 2012;39(5):653–6.

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Deepak Talreja MD, FACC .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer Science+Business Media New York

About this chapter

Cite this chapter

Talreja, D., Geloo, N. (2016). Repair of Paravalvular Leaks. In: Ailawadi, G., Kron, I. (eds) Catheter Based Valve and Aortic Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-3432-4_16

Download citation

  • DOI: https://doi.org/10.1007/978-1-4939-3432-4_16

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-3430-0

  • Online ISBN: 978-1-4939-3432-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics