Percutaneous device closure of paravalvular leak

Calvert, Patrick A.; Northridge, David B.; Malik, Iqbal S.; Shapiro, Leonard; Ludman, Peter; Qureshi, Shakeel A.; Mullen, Michael; Henderson, Robert; Turner, Mark; Been, Martin; Walsh, Kevin P.; Casserly, Ivan; Morrison, Lindsay; Walker, Nicola L.; Thomson, John; Spence, Mark S.; Mahadevan, Vaikom S.; Hoye, Angela; Maccarthy, Philip A.; Daniels, Matthew J.; Clift, Paul; Davies, William R.; Adamson, Philip D.; Morgan, Gareth; Aggarwal, Suneil K.; Ismail, Yasmin; Ormerod, Julian O.M.; Khan, Habib R.; Chandran, Sujay Subash; De Giovanni, Joseph; Rana, Bushra S.; Ormerod, Oliver; Hildick-Smith, David

Abstract

Background: Paravalvular leak (PVL) occurs in 5% to 17% of patients following surgical valve replacement. Percutaneous device closure represents an alternative to repeat surgery. Methods: All UK and Ireland centers undertaking percutaneous PVL closure submitted data to the UK PVL Registry. Data were analyzed for association with death and major adverse cardiovascular events (MACE) at follow-up. Results: Three hundred eight PVL closure procedures were attempted in 259 patients in 20 centers (2004-2015). Patient age was 67±13 years; 28% were female. The main indications for closure were heart failure (80%) and hemolysis (16%). Devices were successfully implanted in 91% of patients, via radial (7%), femoral arterial (52%), femoral venous (33%), and apical (7%) approaches. Nineteen percent of patients required repeat procedures. The target valve was mitral (44%), aortic (48%), both (2%), pulmonic (0.4%), or transcatheter aortic valve replacement (5%). Preprocedural leak was severe (61%), moderate (34%), or mild (5.7%) and was multiple in 37%. PVL improved postprocedure (P

Citation

Calvert, P. A., Northridge, D. B., Malik, I. S., Shapiro, L., Ludman, P., Qureshi, S. A., Mullen, M., Henderson, R., Turner, M., Been, M., Walsh, K. P., Casserly, I., Morrison, L., Walker, N. L., Thomson, J., Spence, M. S., Mahadevan, V. S., Hoye, A., Maccarthy, P. A., Daniels, M. J., …Hildick-Smith, D. (2016). Percutaneous device closure of paravalvular leak. Circulation, 134(13), 934-944. https://doi.org/10.1161/CIRCULATIONAHA.116.022684

• Journal Article Type: Article
• Acceptance Date: Aug 5, 2016
• Online Publication Date: Sep 1, 2016
• Publication Date: Sep 27, 2016
• Deposit Date: Feb 8, 2021
• Journal: Circulation
• Print ISSN: 0009-7322
• Electronic ISSN: 1524-4539
• Publisher: Lippincott, Williams & Wilkins
• Peer Reviewed: Peer Reviewed
• Volume: 134
• Issue: 13
• Pages: 934-944
• DOI: https://doi.org/10.1161/CIRCULATIONAHA.116.022684
• Public URL: https://hull-repository.worktribe.com/output/3588196
• Publisher URL: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.116.022684