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Paravalvular leaks (PVL) are a well-recognized complication of prosthetic valve replacement. Most are asymptomatic and benign, but some may cause symptoms due to a large regurgitant volume or hemolysis. Surgical repair of paravalvular leak carries significant morbidity and mortality. The percutaneous approach of paravalvular leak is emerging as an alternative treatment for high-risk surgical candidates.
We investigated a cohort of patients admitted electively for catheter-based treatment of symptomatic prosthetic paravalvular regurgitation from Jan 2013 to June 2017. Both mitral and aortic valve PVLs were studied. Patients demographics, risk factors, procedural indications and outcomes, In-hospital and thirty-day mortality were all reported.
A total of 22 patients were included (55% aortic & 45% mitral). Average hospital stay was 1-2 days (1.5 days overall cohort, less than 24 hours for the aortic subgroup). All cases were performed under moderate sedation. Technical success of the procedure was 100%. Procedural success as defined by any significant residual shunt was 77%. No procedural death reported. Short-term mortality during the first 30 days was less than 1%.
Elective catheter-based repair of symptomatic prosthetic paravalvular regurgitation appears to be safe and effective. The use of moderate sedation with monitored anesthesia care resulted in short hospital stay.