scholarly journals A081 Percutaneous Closure of a Rapid Deployment Aortic Valve Paravalvular Leak Using Intracardiac Echocardiography

2020 ◽  
Vol 29 ◽  
pp. S34
Author(s):  
C. McAlister ◽  
R. Troughton ◽  
T. Clendon ◽  
J. Blake ◽  
D. Smyth ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Intracardiac Echocardiography ◽  
Percutaneous Closure ◽  
Paravalvular Leak ◽  
Rapid Deployment

Comparison of Self-Expanding RDV Perceval S versus TAVI ACURATE neo/TF

2021 ◽  
Author(s):  
Victor Mauri ◽  
Stephen Gerfer ◽  
Elmar Kuhn ◽  
Matti Adam ◽  
Kaveh Eghbalzadeh ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Implantation Rate ◽  
Paravalvular Leak ◽  
Short Term ◽  
Cerebrovascular Events ◽  
Transcatheter Heart Valve ◽  
All Cause Mortality ◽  
Rapid Deployment

Abstract Background Rapid deployment aortic valve replacement (RDAVR) and transcatheter aortic valve implantation (TAVI) have emerged as increasingly used alternatives to conventional aortic valve replacement to treat patients at higher surgical risk. Therefore, in this single-center study, we retrospectively compared clinical outcomes and hemodynamic performance of two self-expanding biological prostheses, the sutureless and rapid deployment valve (RDV) Perceval-S (PER) and the transcatheter heart valve (THV) ACURATE neo/TF (NEO) in a 1:1 propensity-score-matching (PSM) patient cohort. Methods A total of 332 consecutive patients with symptomatic aortic valve stenosis underwent either singular RDAVR with PER (119) or TAVI with NEO (213) at our institutions between 2012 and 2017. To compare the unequal patient groups, a 1:1 PSM for preoperative data and comorbidities was conducted. Afterward, 59 patient pairs were compared with regard to relevant hemodynamic parameter, relevant paravalvular leak (PVL), permanent postoperative pacemaker (PPM) implantation rate, and clinical postoperative outcomes. Results Postoperative clinical short-term outcomes presented with slightly higher rates for 30-day all-cause mortality (PER = 5.1% vs. NEO = 1.7%, p = 0.619) and major adverse cardiocerebral event in PER due to cerebrovascular events (transient ischemic attack [TIA]-PER = 3.4% vs. TIA-NEO = 1.7%, p = 0.496 and Stroke-PER = 1.7% vs. Stroke-NEO = 0.0%, p = 1). Moreover, we show comparable PPM rates (PER = 10.2% vs. NEO = 8.5%, p = 0.752). However, higher numbers of PVL (mild—PER = 0.0% vs. NEO = 55.9%, p = 0.001; moderate or higher—PER = 0.0% vs. NEO = 6.8%, p = 0.119) after TAVI with NEO were observed. Conclusion Both self-expanding bioprostheses, the RDV-PER and THV-NEO provide a feasible option in elderly and patients with elevated perioperative risk. However, the discussed PER collective showed more postoperative short-term complications with regard to 30-day all-cause mortality and cerebrovascular events, whereas the NEO showed higher rates of PVL.

scholarly journals Management of severe haemolytic anaemia due to residual small mitral paravalvular leak post-percutaneous closure: a case report

2020 ◽  
Vol 4 (3) ◽  
pp. 1-6
Author(s):  
Reda Abuelatta ◽  
Lamiaa Khedr ◽  
Ibraheem AlHarbi ◽  
Hesham A Naeim
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Haemolytic Anaemia ◽  
Three Dimensional ◽  
Kidney Injury ◽  
Interatrial Septum ◽  
Percutaneous Closure ◽  
Paravalvular Leak ◽  
Packed Red Blood Cells ◽  
Small Leak

Abstract Background Haemolytic anaemia is a complication of paravalvular leak (PVL). The correlation between the size of the leak and the severity of haemolysis is unclear. Small leaks can cause severe haemolysis, whereas significant leaks may cause no haemolysis. Case summary We report the case of a 40-year-old male who underwent mechanical mitral and aortic valve replacement 20 years ago. In the last 3 years, the procedure was repeated three times due to infective endocarditis. He presented with severe shortness of breath. A transoesophageal echocardiogram with three-dimensional surgical view showed that both discs of the mechanical mitral valve opened sufficiently but a severe PVL had occurred at the 9–12 o’clock position. The location of the mitral valve was abnormal, the sewing ring was inserted high at the mid-interatrial septum. The mechanical aortic valve functioned well. Closure of the transcutaneous PVL was accomplished with two percutaneously implanted devices, leaving a small leak in between. After closure, he developed haemolytic anaemia (haemoglobin: 6 g/dL, lactate dehydrogenase: 1896 units/L, reticulocyte count: 4.6%). He then received 16 units of packed red blood cells. He developed acute kidney injury and was started on haemodialysis. We then installed two additional devices to completely close the mild residual leak and another device to resolve the bidirectional transseptal defect. After 2 days, his renal function returned to normal and anaemia improved (haemoglobin: 9.1 g/dL). Discussion Mild residual paravalvular leak can cause severe haemolytic anaemia that is correctable via percutaneous closure of the leak.

Mitral and Aortic Valve Prosthetic Endocarditis After Percutaneous Closure of Mitral Paravalvular Leak

2013 ◽  
Vol 95 (2) ◽  
pp. e45-e46
Author(s):  
Pietro Giorgio Malvindi ◽  
Giuseppe Maria Raffa ◽  
Antioco Cappai ◽  
Alessandro Barbone ◽  
Alessio Basciu ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Percutaneous Closure ◽  
Paravalvular Leak

scholarly journals Aortic Annulus Stabilization Technique for Rapid Deployment Aortic Valve Replacement

2015 ◽  
Vol 10 (5) ◽  
pp. 360-362 ◽  
Author(s):  
Enrico Ferrari ◽  
Giuseppe Siniscalchi ◽  
Piergiorgio Tozzi ◽  
Ludwig von Segesser
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Pacemaker Implantation ◽  
Aortic Annulus ◽  
Paravalvular Leak ◽  
Aortic Valves ◽  
A New Technique ◽  
Stabilization Technique ◽  
Rapid Deployment

Rapid deployment aortic valve replacement (RDAVR) with the use of rapid deployment valve systems represents a smart alternative to the use of standard aortic bioprosthesis for aortic valve replacement. Nevertheless, its use is still debatable in patients with pure aortic valve regurgitation or true bicuspid aortic valve because of the risk of postoperative paravalvular leak. To address this issue, an optimal annulus-valve size match seems to be the ideal surgical strategy. This article describes a new technique developed to stabilize the aortic annulus and prevent paravalvular leak after RDAVR. To confirm the feasibility, this technique was performed in six patients with severe symptomatic aortic stenosis who were scheduled to undergo aortic valve replacement at our center. All patients survived surgery and were discharged from the hospital. There were no new intracardiac conduction system disturbances observed, and a permanent pacemaker implantation was not required in any of the patients. The intraoperative and postoperative echocardiogram confirmed successful positioning of the valve, and no paravalvular leak was observed. In this preliminary experience, RDAVR through a full sternotomy or an upper hemisternotomy approach with the use of aortic annulus stabilization technique was safe, and no leak was observed. Future studies on large series of patients are necessary to confirm the safety and effectiveness of this technique in preventing paravalvular leak in patients with true bicuspid aortic valves or pure aortic regurgitation.

Paravalvular Leak Leading to Severe Aortic Valve Regurgitation after TAVI: Percutaneous Closure Strategy

2015 ◽  
Vol 24 (9) ◽  
pp. 936-939 ◽  
Author(s):  
Marco Luciano Rossi ◽  
Guido Belli ◽  
Paolo Pagnotta ◽  
Carla Lucarelli ◽  
Patrizia Presbitero
Keyword(s):  
Aortic Valve ◽  
Percutaneous Closure ◽  
Paravalvular Leak ◽  
Valve Regurgitation ◽  
Aortic Valve Regurgitation

Minimally Invasive Implantation of the EDWARDS INTUITY Rapid Deployment Aortic Valve via a Right Minithoracotomy

2015 ◽  
Vol 10 (3) ◽  
pp. 215-217 ◽  
Author(s):  
Aristidis Lenos ◽  
Anno Diegeler
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Minimally Invasive ◽  
Valve Replacement ◽  
Pacemaker Implantation ◽  
Paravalvular Leak ◽  
Hemodynamic Performance ◽  
Invasive Techniques ◽  
Rapid Deployment

During the past decade, many surgeons have focused their interest on the development and improvement of minimally invasive techniques for aortic valve replacement. Although the minimally invasive approaches for the treatment of mitral valve disease have been standardized, the preferred route for aortic valve replacement remains a matter of debate. Access through a right minithoracotomy avoids opening the sternum; however, it requires a greater surgical ability and a learning period, even for experienced surgeons. This enhances the role of sutureless prostheses because these devices are associated with easier placement, excellent hemodynamic performance, and acceptable rates of pacemaker implantation and paravalvular leak. Herein, we report a series of 10 consecutive patients who received an EDWARDS INTUITY rapid deployment valve (Edwards Lifesciences, Irvine, CA USA) by a right minithoracotomy.

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