Percutaneous Closure of Mitral Paravalvular Leaks in Patients With Aortic Valve Prostheses

2012 ◽  
Vol 65 (8) ◽  
pp. 768-769
Author(s):  
Raul Moreno ◽  
Angel Sanchez Recalde ◽  
Teresa Lopez Fernández ◽  
Isidro Moreno-Gomez ◽  
Jose M. Mesa ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Percutaneous Closure ◽  
Valve Prostheses

Pulmonary Homografts for Aortic Valve Replacement: Long-term Comparison with Aortic Grafts

2011 ◽  
Vol 14 (4) ◽  
pp. 237 ◽  
Author(s):  
Ferdinand Vogt ◽  
Anke Kowert ◽  
Andres Beiras-Fernandez ◽  
Martin Oberhoffer ◽  
Ingo Kaczmarek ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Survival Rates ◽  
Long Term Results ◽  
Rank Test ◽  
Aortic Graft ◽  
Valve Prostheses ◽  
Retrospective Comparative Study

<p><b>Objective:</b> The use of homografts for aortic valve replacement (AVR) is an alternative to mechanical or biological valve prostheses, especially in younger patients. This retrospective comparative study evaluated our single-center long-term results, with a focus on the different origins of the homografts.</p><p><b>Methods:</b> Since 1992, 366 adult patients have undergone AVR with homografts at our center. We compared 320 homografts of aortic origin and 46 homografts of pulmonary origin. The grafts were implanted via either a subcoronary technique or the root replacement technique. We performed a multivariate analysis to identify independent factors that influence survival. Freedom from reintervention and survival rates were calculated as cumulative events according to the Kaplan-Meier method, and differences were tested with the log-rank test.</p><p><b>Results:</b> Overall mortality within 1 year was 6.5% (21/320) in the aortic graft group and 17.4% (8/46) in the pulmonary graft group. In the pulmonary graft group, 4 patients died from valve-related complications, 1 patient died after additional heterotopic heart transplantation, and 1 patient who entered with a primary higher risk died from a prosthesis infection. Two patients died from non-valve-related causes. During the long-term follow-up, the 15-year survival rate was 79.9% for patients in the aortic graft group and 68.7% for patients in the pulmonary graft group (<i>P</i> = .049). The rate of freedom from reoperation was 77.7% in the aortic graft group and 57.4% in the pulmonary graft group (<i>P</i> < .001). The reasons for homograft explantation were graft infections (aortic graft group, 5.0%; pulmonary graft group, 6.5%) and degeneration (aortic graft group, 7.5%; pulmonary graft group, 32.6%).</p><p><b>Conclusion:</b> Our study demonstrated superior rates of survival and freedom from reintervention after AVR with aortic homografts. Implantation with a pulmonary graft was associated with a higher risk of redo surgery, owing to earlier degenerative alterations.</p>

Doppler ultrasound of normally functioning mechanical mitral and aortic valve prostheses

1988 ◽  
Vol 18 (3) ◽  
pp. 391-398 ◽  
Author(s):  
John L. Gibbs ◽  
Gill A. Wharton ◽  
Gordon J. Williams
Keyword(s):  
Aortic Valve ◽  
Doppler Ultrasound ◽  
Valve Prostheses

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.

Echocardiographic Imaging of Stentless Aortic Valve Prostheses

2000 ◽  
Vol 17 (7) ◽  
pp. 625-629
Author(s):  
Leo H.B. Baur ◽  
Kathinka Peels ◽  
Jerry Braun ◽  
Arie-Pieter Kappetein ◽  
Marianne Bootsma ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Valve Prostheses

scholarly journals Predictors of Early Mortality After Aortic Valve Replacement in Middle-Aged Rheumatic Patients

2019 ◽  
Vol 1 (3) ◽  
pp. 105-111
Author(s):  
Essam Hassan ◽  
Sameh Sersar
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Median Sternotomy ◽  
Early Postoperative Period ◽  
Early Mortality ◽  
P Value ◽  
The Mean ◽  
Valve Prostheses ◽  
Rheumatic Patients

Background: Several risk factors, including emergency surgery, predicted early mortality after aortic valve replacement (AVR).  Euroscore II is used to predict the mortality after cardiac operations. We aimed to review our experience in AVR and determine the early mortality predictors Methods: We collected the data of 200 rheumatic patients who had standard AVR in two centers. Median sternotomy and cardiopulmonary bypass were used in all patients. Transcatheter and minimally invasive aortic valve replacement patients were excluded. We used 15 types of aortic valve prostheses, either mechanical or biological. Follow-up echocardiography was done in the intensive care unit, on discharge, and one month after discharge.     Results: 128 patients (64%) had mechanical AVR, and 130 patients (65%) were males. The mean age was 48.2 ± 19 years, and body mass index was 1.8 ± 0.2 Kg/m2. The mean preoperative ejection fraction was 54 ± 9.4 %, end-diastolic dimension was 5.3 ± 0.8 cm, and end-systolic dimension was 3.5 ± 0.9 cm. Nine patients (4.5%) died in the early postoperative period (6 months). Euroscore II was the only factor significantly associated with early mortality (P value= 0.031).  The mean Euroscore II was 1.3 ± 0.9 and 10.1 ± 10.7 for survivors and non-survivors, respectively.  Conclusion: Euroscore II score was significantly associated with early mortality after aortic valve replacement in rheumatic patients and can be used for risk stratification in those patients.

Pannus formation in aortic valve prostheses in the late postoperative period

2003 ◽  
Vol 6 (3) ◽  
pp. 179-182 ◽  
Author(s):  
Yukio Kuniyoshi ◽  
Kageharu Koja ◽  
Kazufumi Miyagi ◽  
Mituyoshi Shimoji ◽  
Tooru Uezu ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Postoperative Period ◽  
Pannus Formation ◽  
Valve Prostheses ◽  
Late Postoperative Period
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