AIM To analyze retrospectively the surgical results and follow-up results of transcatheter closure of perivalvular leakage (PVL) after mechanical valve replacement.
METHODS From January 2018 to December 2021, a total of PVL 93 patients after mechanical valve replacement were chosen for the study. All the patients underwent transcatheter closure in Xijing Hospital and their surgical approach, catheter technology, perioperative characteristics and prognosis were reviewed and analyzed. The median follow-up time was 27 (3,48) months.
RESULTS There was no statistical difference between the two groups in gender, age, previous surgery (aortic valve replacement alone, mitral valve replacement alone and aortic valve combined mitral valve replacement), valve replacement time, previous endocarditis history, hemolysis, preoperative cardiac function grade (NYHA class II, NYHA class III and NYHA class IV), preoperative left ventricular ejection fraction (LVEF), PVL severity, comorbidities, NT-proBNP and ibil. In the case of no statistical difference between the two groups in other perioperative indicators (success rate of surgery, surgical path, type and quantity of occluder and anesthesia mode), the exposure time (fluoroscopy time of digital subtraction angiography) and the operation time of the 3D printing group were shorter than those of the control group (all P<0.05). Compared with the control group, the cardiac function (NYHA classification) of the 3D printing group was improved in different degrees (P<0.05); There was no significant difference in left ventricular ejection fraction (LVEF), NT-proBNP and indirect bilirubin (IBIL). Compared with that before follow-up, the NT-proBNP level decreased to normal (P<0.05), and the indirect bilirubin (IBIL) level gradually decreased to normal after the operation (P<0.05).
CONCLUSION Transcatheter closure of PVL after mechanical valve replacement requires complex catheter technology and the medium and long-term follow-up results show its safety and effectiveness.
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