Safety and efficacy of transcatheter closure of paravalvular leakage: Clinical experience of 42 cases

  AIM   To evaluate the safety and efficacy of transcatheter intervention of paravalvular leakage (PVL) after valve replacement.

  METHODS   Between May 2016 to May 2017, 42 patients of PVL after valve replacement underwent interventional therapy. There were 24 males and 18 females with mean age of (51.5±11.6) years. Previously, 15 patients underwent mitral valve replacement only, 13 patients underwent aortic valve replacement only, 9 patients had aortic valve replacement and mitral valve replacement, 2 patients underwent TVR, 3 patients underwent mitral valve replacement and coronary artery bypass grafting. 10 patients had a history of previous infective endocarditis. 25 patients used mechanical valve and the other 17 patients used biological valve. Transcatheter intervention was carried out in the catheterization laboratory or the hybrid operation room with the patient under local anesthesia first. Follow-up evaluation included peri-operational mortality, complications and postoperative residual shunt. The average follow-up time was 1 to 36 months.

  RESULTS   The success rate of transcatheter intervention was 95%, apart from 2 patients who were implanted with no occlusion. The main post-operative complications included 1case of acute renal failure (2%), 2 cases of hematuria (5%) and 5 cases of blood transfusion (12%), During the follow-up, there were no deaths. The regurgitation volume decreased to (0.54±0.74) ml (P<0.05). The remaining 40 patients did well, with improved heart function and no serious complications.

  CONCLUSION   Transcatheter intervention of PVL has the advantages of being a simpler and safer approach, less trauma, shorter time of hospitalization, faster post-operative recovery. For patients with appropriate indications, it should be the first choice of treatment.