Paravalvular Leaks

  • Nina Wunderlich
  • Jennifer Franke
  • Stefan C. Bertog
  • Neil Wilson
  • Horst Sievert
Chapter

Abstract

Paravalvular leaks are not uncommon after surgical valve replacement. Re-operation is associated with a higher risk than the initial surgery, and co-morbidities may preclude redo surgery. Therefore, percutaneous treatment options have been explored. This chapter serves to provide an overview of percutaneous paravalvular leak treatment with focus on optimal imaging, technical procedural aspects and complications. A routine case as well as a technically challenging case are presented, demonstrating important problems frequently encountered with these complex procedures, and tips and potential solutions to the management of procedural problems and difficulties are provided.

Keywords

Left Atrium Amplatzer Vascular Plug Transseptal Puncture Paravalvular Leak Coronary Catheter 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Pate GE, Zubaidi A, Chandavimol M, Thompson CR, Munt BI, Webb JG (2006) Percutaneous closure of prosthetic paravalvular leaks: case series and review. Catheter Cardiovasc Interv 68:528–533PubMedCrossRefGoogle Scholar
  2. 2.
    Safi AM, Kwan T, Afflu E, Al Kamme A, Salcicciolo L (2000) Paravalvular regurgitation: a rare complication following valve replacement surgery. Angiology 51:479–487PubMedCrossRefGoogle Scholar
  3. 3.
    Hammermeister K, Sethi G, Henderson W, Grover F, Oprian C, Rahimtoola S (2000) Outcomes 15 years after valve replacement with a mechanical versus a bioprosthetic valve: final report of the Veterans Affairs randomized trial. J Am Coll Cardiol 36:1152–1158PubMedCrossRefGoogle Scholar
  4. 4.
    Kronzon I, Sugeng L, Perk G, Hirsh D, Weinert L, Garcia-Fernandez MA, Lang RM (2009) Real- time 3-dimensional transesophageal echocardiography in the evaluation of post-operative mitral annuloplasty ring and prosthetic valve dehiscence. J Am Coll Cardiol 53:1543–1547PubMedCrossRefGoogle Scholar
  5. 5.
    Pate G, Webb J, Thompson C, Munt B, Chugh S, Carere R, Moss R (2004) Percutaneous closure of a complex prosthetic mitral paravalvular leak using transesophageal echocardiographic guidance. Can J Cardiol 20:452–455PubMedGoogle Scholar
  6. 6.
    Echevarria JR, Bernal JM, Rabasa JM, Morales D, Revila Y, Revuelta JM (1991) Reoperation for bioprosthetic valve dysfunction. A decade of clinical experience. Eur J Cardiothorac Surg 5:523–526; ­discussion 527PubMedCrossRefGoogle Scholar
  7. 7.
    Hourihan M, Perry SB, Mandell VS et al (1992) Transcatheter umbrella closure of valvular and paravalvular leaks. J Am Coll Cardiol 20(6):1371–1377PubMedCrossRefGoogle Scholar
  8. 8.
    Hein R, Wunderlich N, Robertson G, Wilson N, Sievert H (2006) Catheter closure of paravalvular leak. EuroIntervention 3:318–325Google Scholar
  9. 9.
    Del Valle-Fernandez R, Martinez C, Jelnin V, Ruiz CE (2009) Paravalvular leak closure: single-center experience. Eur Heart J 30(Abstract suppl):920Google Scholar
  10. 10.
    Bernal J, Rabasa J, Gutuerrez-Garcia F, Morales C, Nistal J, Revuelta J (1998) The Carbomedics valve: experience with 1.049 implants. Ann Thorac Surg 65:137–144PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Nina Wunderlich
    • 1
  • Jennifer Franke
    • 1
  • Stefan C. Bertog
    • 1
    • 2
  • Neil Wilson
    • 3
  • Horst Sievert
    • 1
  1. 1.CardioVascular Center FrankfurtFrankfurtGermany
  2. 2.Department of invasive CardiologyMinneapolis Veterans Affairs Medical CenterMinneapolisUSA
  3. 3.Department of interventional pediatric cardiologyJohn Radcliffe HospitalOxfordUK

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