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Jenab Y, Nourian S, Hosseini Mohammadi NS, Mohseni‐Badalabadi R, Hosseini K, Zakavi S, Ates I. Complications of transcatheter paravalvular leak device closure of mitral valve: An updated review of the literature and a rare case presentation. Clin Cardiol 2024; 47:e24272. [PMID: 38742736 PMCID: PMC11092304 DOI: 10.1002/clc.24272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 04/01/2024] [Accepted: 04/11/2024] [Indexed: 05/16/2024] Open
Abstract
Paravalvular leak (PVL) is an uncommon complication of prosthetic valve implantation, which can lead to infective endocarditis, heart failure, and hemolytic anemia. Surgical reintervention of PVLs is associated with high mortality rates. Transcatheter PVL closure (TPVLc) has emerged as an alternative to surgical reoperation. This method provides a high success rate with a low rate of complications. This article reviews the pathogenesis, clinical manifestation, diagnosis, and management of PVL and complications following TPVLc. Besides, we presented a case of a patient with severe PVL following mitral valve replacement, who experienced complete heart block (CHB) during TPVLc. The first TPVLc procedure failed in our patient due to possible AV-node insult during catheterization. After 1 week of persistent CHB, a permanent pacemaker was implanted. The defect was successfully passed using the previous attempt. Considering the advantages of TPVLc, procedure failure should be regarded as a concern. TPVLc should be performed by experienced medical teams in carefully selected patients.
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Affiliation(s)
- Yaser Jenab
- Tehran Heart Center, Cardiovascular Diseases Research InstituteTehran University of Medical SciencesTehranIran
| | - Saeed Nourian
- Firoozgar Clinical Research and Development CenterIran University of Medical SciencesTehranIran
| | - Negin Sadat Hosseini Mohammadi
- Tehran Heart Center, Cardiovascular Diseases Research InstituteTehran University of Medical SciencesTehranIran
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research InstituteTehran University of Medical ScienceTehranIran
| | - Reza Mohseni‐Badalabadi
- Tehran Heart Center, Cardiovascular Diseases Research InstituteTehran University of Medical SciencesTehranIran
| | - Kaveh Hosseini
- Tehran Heart Center, Cardiovascular Diseases Research InstituteTehran University of Medical SciencesTehranIran
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research InstituteTehran University of Medical ScienceTehranIran
| | - Sarina Zakavi
- Tehran Heart Center, Cardiovascular Diseases Research InstituteTehran University of Medical SciencesTehranIran
- Students' Scientific Research Center (SSRC)Tehran University of Medical ScienceTehranIran
| | - Ismail Ates
- Faculty of HealthscienceBahcesehir UniversityIstanbulTurkey
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Aigner P, Sella Bart E, Panfili S, Körner T, Mach M, Andreas M, Königshofer M, Saitta S, Redaelli A, Schmid A, Moscato F. Quantification of paravalvular leaks associated with TAVI implants using 4D MRI in an aortic root phantom made possible by the use of 3D printing. Front Cardiovasc Med 2023; 10:1083300. [PMID: 36742071 PMCID: PMC9894656 DOI: 10.3389/fcvm.2023.1083300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 01/02/2023] [Indexed: 01/21/2023] Open
Abstract
Introduction Transcatheter aortic valve implantation (TAVI) has become an alternative to surgical replacement of the aortic valve elderly patients. However, TAVI patients may suffer from paravalvular leaks (PVL). Detecting and grading is usually done by echocardiography, but is limited by resolution, 2D visualization and operator dependency. 4D flow magnetic resonance imaging (MRI) is a promising alternative, which did not reach clinical application in TAVI patients. The aim of this study was applying 3D printing technologies in order to evaluate flow patterns and hemodynamics of PVLs following TAVI, exploiting 4D flow MRI and standard ultrasound. Materials and methods An MR-compatible, anatomically left ventricle, aortic root, and ascending aorta model was fabricated by combining 3D-printed parts and various soft silicone materials to match physiological characteristics. An Abbott Portico™ valve was used in continuous antegrade flow (12-22 l/min), retrograde flow with varying transvalvular pressures (60-110 mmHg), and physiological pulsatile hemodynamics (aortic pressure: 120/80 mmHg, cardiac output: 5 l/min) Time-resolved MR measurements were performed above and below the TAVI stent and compared with color Doppler ultrasound measurements in exactly the same setup. Results The continuous antegrade flow measurements from MRI largely agreed with the flowmeter measurements, and a maximum error of only 7% was observed. In the retrograde configuration, visualization of the paravalvular leaks was possible from the MR measurements, but flow was overestimated by up to 33%. The 4D MRI measurement in the pulsatile setup revealed a single main PVL, which was also confirmed by the color Doppler measurements, and velocities were similar (2.0 m/s vs. 1.7 m/s). Discussion 4D MRI techniques were used to qualitatively assess flow in a patient-specific, MR-compatible and flexible model, which only became possible through the use of 3D printing techniques. Flow patterns in the ascending aorta, identification and quantification of PVLs was possible and the location and extent of PVLs were confirmed by ultrasound measurements. The 4D MRI flow technique allowed evaluation of flow patterns in the ascending aorta and the left ventricle below the TAVI stent with good results in identifying PVLs, demonstrating its capabilities over ultrasound by providing the ability to visualize the paravalvular jets in three dimensions at however, additional expenditure of time and money.
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Affiliation(s)
- Philipp Aigner
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria,Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria,*Correspondence: Philipp Aigner,
| | - Eleonora Sella Bart
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria,Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Sebastiano Panfili
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria,Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Tito Körner
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Markus Mach
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - Martin Andreas
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - Markus Königshofer
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Simone Saitta
- Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Alberto Redaelli
- Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Albrecht Schmid
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Francesco Moscato
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria,Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria,Austrian Cluster for Tissue Regeneration, Vienna, Austria
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Dun Y, Shi Y, Guo H, Liu Y, Qian X, Sun X, Yu C. Outcome of reoperative aortic root or ascending aorta replacement after prior aortic valve replacement. J Thorac Dis 2021; 13:1531-1542. [PMID: 33841945 PMCID: PMC8024838 DOI: 10.21037/jtd-20-3081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Background There are limited data regarding the clinical outcomes of reoperative aortic root or ascending aorta replacement after prior aortic valve replacement (AVR). We aimed to analyze outcomes of reoperative aortic root or ascending aorta replacement after prior AVR. Methods Eighty patients with prior AVR underwent reoperative aortic root or ascending aorta replacement in our hospital. The indications were root or ascending aortic aneurysm in 36 patients, root or ascending aortic dissection in 37, root false aneurysm in 2, prosthesis valve endocarditis (PVE) with root abscess in 2, Behçet’s disease (BD) with root destruction in 3 patients. An elective surgery was performed in 63 patients and an emergent surgery in 17. The survival and freedom from aortic events during the follow-up were evaluated with the Kaplan-Meier survival curve and the log-rank test. Results The operative techniques included ascending aorta replacement in 14 patients, ascending aorta replacement with AVR in 3, prosthesis-sparing root replacement (PSRR) in 35, Bentall procedure in 24, and Cabrol procedure in 4 patients. Operative mortality was 1.3% (1/80). A composite of adverse events occurred in 5 patients, including 1 operative death, 2 stroke and 3 renal failure necessitating hemodialysis. The mean follow-up was 35.5±22.1 months. Five late deaths occurred. The Kaplan-Meier survival at 1 year, 3 years and 6 years were 97.5%, 91.1% and 84.1%, respectively. Aortic events developed in 3 patients. The freedom from aortic events at 1-year, 3-year, and 6-year were 100%, 96.3% and 88.9%, respectively. There were no differences in survival and freedom from aortic events between the elective group and the emergent group. Conclusions Reoperative aortic root or ascending aorta replacement after prior AVR could be performed to treat the root or ascending pathologies after AVR, with satisfactory early and midterm outcomes.
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Affiliation(s)
- Yaojun Dun
- Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yi Shi
- Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hongwei Guo
- Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yanxiang Liu
- Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiangyang Qian
- Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaogang Sun
- Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Cuntao Yu
- Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Wu W, Ke Y, Zhao H, Huang L, Pu J. Trans-catheter closure of aortic anastomosis leak after aortic replacement: classifications and techniques. J Thorac Dis 2020; 12:4883-4891. [PMID: 33145062 PMCID: PMC7578451 DOI: 10.21037/jtd-20-1496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Aortic anastomotic leak (AAL) is knotty complication after aortic replacement. We aimed to evaluate the feasibility and efficacy of the techniques of trans-catheter AAL closure as well as to evaluate the impact of the new classification on the interventional closure. Methods From October 2015 to November 2017, 20 consecutive high surgical risk patients (mean age 47±12 years, 13 males) were referred to our center for trans-catheter closure AALs. Due to the variation of leak, we therefore developed a new-classification based on transesophageal echocardiography (TEE) and computed tomography angiography (CTA) assessments: type I: aorta-to-right atrium fistula, n=6; type II: pseudoaneurysm induced by a suture line dehiscence, n=4; type III: patency of the false lumen in aortic dissection, n=10. Outcomes were analyzed by assessing TEE and CTA in different types of AALs. Results Successful closure was accomplished in 17 subjects (85%). The severity of AAL reduced significantly in 15 patients (88%); two patients required a second procedure. At follow-up, we found that in type I, the right atrium systolic pressure reduced (from 25.3±4.1 to 7.0±1.2 mmHg) with the improved NYHA (3.5±0.6 vs. 1.0±0.0), the diameter of pseudoaneurysm significantly decreased (5.0±1.8 to 2.0±1.8 mm) in type II, and complete thrombosis was achieved in all type III patients. Conclusions Trans-catheter closure of AAL displays satisfactory results even in those defined as high-risk patients, and it could be considered be a viable alternative approach. New classification is helpful in decision-making.
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Affiliation(s)
- Wenhui Wu
- Interventional Department, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yutong Ke
- Echocardiography Department, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Honglei Zhao
- Cardiology Surgery Department, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Lianjun Huang
- Interventional Department, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Junzhou Pu
- Interventional Department, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
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Okutucu S, Mach M, Oto A. Mitral Paravalvular Leak Closure: Transcatheter and Surgical Solutions. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2020; 21:422-431. [DOI: 10.1016/j.carrev.2019.06.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 06/17/2019] [Accepted: 06/25/2019] [Indexed: 11/29/2022]
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Joseph TA, Lane CE, Fender EA, Zack CJ, Rihal CS. Catheter-based closure of aortic and mitral paravalvular leaks: existing techniques and new frontiers. Expert Rev Med Devices 2018; 15:653-663. [DOI: 10.1080/17434440.2018.1514257] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Timothy A. Joseph
- Department of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Colleen E. Lane
- Department of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Erin A. Fender
- Department of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Chad J. Zack
- Department of Cardiology, Duke University School of Medicine, Durham, NC, USA
| | - Charanjit S. Rihal
- Department of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, MN, USA
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Ruparelia N, Cao J, Newton JD, Wilson N, Daniels MJ, Ormerod OJ. Paravalvular leak closure under intracardiac echocardiographic guidance. Catheter Cardiovasc Interv 2017; 91:958-965. [PMID: 29024359 DOI: 10.1002/ccd.27318] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 08/05/2017] [Indexed: 11/11/2022]
Abstract
OBJECTIVES The objective of this study was to determine the safety and efficacy of intracardiac echocardiography (ICE) to guide percutaneous paravalvular leak (PVL) closure. BACKGROUND PVL following surgical valve replacement occurs in 2%-15% of patients. Percutaneous treatment is an accepted management strategy in patients deemed to be too high risk for redo surgery. This is most commonly performed with transesophageal (TOE) guidance requiring general anesthesia that both potentially further increase the risk of intervention. ICE can be used to guide intervention, facilitating procedures to be performed under local anesthesia without esophageal intubation potentially making procedures shorter and safer and further enabling the treatment of patients that may have been turned down for intervention. METHODS All patients that underwent ICE-guided percutaneous transcatheter PVL closure between 2006 and 2016 at the John Radcliffe Hospital, Oxford, United Kingdom were retrospectively analyzed. RESULTS Twenty-one procedures were performed in 18 patients during the study period. Fourteen patients (77.8%) underwent successful ICE guided PVL closure. There were no ICE-related complications. Eleven patients (78.6%) reported symptomatic improvement of at least one New York Heart Association (NYHA) Class and the remaining 3 patients had no change. No patient demonstrated objective evidence of persistent hemolysis following successful closure. There was one death within 30 days of the procedure and 1 year survival was 71.4%. CONCLUSIONS Percutaneous paravalvular leak closure guided by ICE without the requirement of general anesthesia is feasible, safe, and associated with acceptable procedural success rates.
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Affiliation(s)
- Neil Ruparelia
- Department of Cardiology, Oxford Heart Centre, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, United Kingdom
| | - Jacob Cao
- Department of Cardiology, Oxford Heart Centre, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, United Kingdom
| | - James D Newton
- Department of Cardiology, Oxford Heart Centre, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, United Kingdom
| | - Neil Wilson
- Department of Cardiology, Oxford Heart Centre, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, United Kingdom.,Department of Paediatrics-Cardiology, Children's Hospital Colorado, Aurora, Colorado 80045
| | - Matthew J Daniels
- Department of Cardiology, Oxford Heart Centre, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, United Kingdom
| | - Oliver J Ormerod
- Department of Cardiology, Oxford Heart Centre, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, United Kingdom
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Bouhout I, Ghoneim A. Rethinking Mitral Paravalvular Leak Closure. JACC Cardiovasc Interv 2017; 10:1957-1958. [DOI: 10.1016/j.jcin.2017.08.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 08/27/2017] [Indexed: 11/30/2022]
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Surgery Versus Transcatheter Interventions for Significant Paravalvular Prosthetic Leaks. JACC Cardiovasc Interv 2017; 10:1959-1969. [DOI: 10.1016/j.jcin.2017.08.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 07/26/2017] [Accepted: 08/03/2017] [Indexed: 11/21/2022]
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Bedair R, Morgan G, Bapat V, Kapetanakis S, Goreczny S, Simpson J, Qureshi S. Early experience with the Occlutech PLD occluder for mitral paravalvar leak closure through a hybrid transapical approach. EUROINTERVENTION 2016; 12:e1420-e1427. [DOI: 10.4244/eijy15m12_07] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Nietlispach F, Maisano F, Sorajja P, Leon MB, Rihal C, Feldman T. Percutaneous paravalvular leak closure: chasing the chameleon. Eur Heart J 2016; 37:3495-3502. [DOI: 10.1093/eurheartj/ehw165] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 03/16/2016] [Accepted: 04/03/2016] [Indexed: 11/13/2022] Open
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Bouhout I, Mazine A, Ghoneim A, Millàn X, El-Hamamsy I, Pellerin M, Cartier R, Demers P, Lamarche Y, Bouchard D. Long-term results after surgical treatment of paravalvular leak in the aortic and mitral position. J Thorac Cardiovasc Surg 2016; 151:1260-6.e1. [DOI: 10.1016/j.jtcvs.2015.11.046] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 11/22/2015] [Accepted: 11/28/2015] [Indexed: 12/01/2022]
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Percutaneous transcatheter closure of mitral paravalvular leak via transarterial retrograde approach. JOURNAL OF GERIATRIC CARDIOLOGY : JGC 2016; 12:683-6. [PMID: 26788047 PMCID: PMC4712376 DOI: 10.11909/j.issn.1671-5411.2015.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Repeat surgery has usually been considered the first choice to solve paravalvular leaks of prosthetic valves, but it carries a high operative risk, a high mortality rate and an increased risk for re-leaks. Percutaneous closure of such defects is possible, and different approaches and devices are used for this purpose. For mitral paravalvular leaks, constructing an arterio-venous wire loop for delivering the closure device through an antegrade approach is the most commonly used technique. Transcatheter closure can also be performed through a transapical approach or retrograde transfemoral arterial approach. We present a case of 68-year-old man with a mitral paravalvular leak that was successfully closed using an Amplatzer® Duct Occluder II, via retrograde transfemoral arterial approach under three-dimensional transesophageal echocardiographic guidance, without the use of a wire loop. The initial attempt to cross the paravalvular defect was unsuccessful, but the obstacle was finally overcome by introducing complex interventional techniques.
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Chrysohoou C, Hayek SS, Spilias N, Lerakis S. Echocardiographic and clinical factors related to paravalvular leak incidence in low-gradient severe aortic stenosis patients post-transcatheter aortic valve implantation. Eur Heart J Cardiovasc Imaging 2014; 16:558-63. [DOI: 10.1093/ehjci/jeu288] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2014] [Accepted: 11/17/2014] [Indexed: 11/14/2022] Open
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García del Blanco B, Hernández Hernández F, Rumoroso Cuevas JR, Trillo Nouche R. Spanish Cardiac Catheterization and Coronary Intervention Registry. 23rd official report of the Spanish Society of Cardiology Working Group on Cardiac Catheterization and Interventional Cardiology (1990-2013). ACTA ACUST UNITED AC 2014; 67:1013-23. [PMID: 25455754 DOI: 10.1016/j.rec.2014.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 08/17/2014] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND OBJECTIVES The Working Group on Cardiac Catheterization and Interventional Cardiology presents its yearly report on the data from the registry of the activity in Spain corresponding to 2013. METHODS The centers introduce their data online voluntarily and the information is analyzed by the Steering Committee of the Working Group on Cardiac Catheterization. RESULTS In 2013, 104 hospitals sent their data (72 public centers and 32 private). In all, 136 715 diagnostic studies were performed (120 358 coronary angiograms), with a slight decrease with respect to 2012, a reduction that was also observed in the rate, which was 2944 diagnostic studies per million population. A total of 65 912 interventional procedures were carried out during a phase of stability, for a rate of 1419 interventions per million population. Other techniques included the implantation of 99 417 stents and 1384 biodegradable intracoronary devices (64% of them drug-eluting devices). There were 18 337 procedures in acute myocardial infarction, for an increase of 7% with respect to 2012 and representing 27.8% of all the percutaneous coronary interventions. Radial access was the approach used in 71% of the diagnostic procedures and in 65% of the interventional procedures. The performance of renal denervation has nearly doubled with respect to 2012. For the first time, more than 1000 transcatheter aortic valve implantation procedures were carried out in 1 year, although the frequency increased only slightly (23%). CONCLUSIONS There continued to be a slight increase in the activity in cardiac catheterization in association with ST-segment elevation myocardial infarction, whereas, with the exception of recently introduced, highly specific procedures, the use of the remainder of the procedures, among them transcatheter aortic valve implantation, leveled off.
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Affiliation(s)
- Bruno García del Blanco
- Junta Directiva, Sección de Hemodinámica y Cardiología Intervencionista, Sociedad Española de Cardiología, Madrid, Spain.
| | - Felipe Hernández Hernández
- Junta Directiva, Sección de Hemodinámica y Cardiología Intervencionista, Sociedad Española de Cardiología, Madrid, Spain
| | - José Ramón Rumoroso Cuevas
- Junta Directiva, Sección de Hemodinámica y Cardiología Intervencionista, Sociedad Española de Cardiología, Madrid, Spain
| | - Ramiro Trillo Nouche
- Junta Directiva, Sección de Hemodinámica y Cardiología Intervencionista, Sociedad Española de Cardiología, Madrid, Spain
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Registro Español de Hemodinámica y Cardiología Intervencionista. XXIII Informe Oficial de la Sección de Hemodinámica y Cardiología Intervencionista de la Sociedad Española de Cardiología (1990-2013). Rev Esp Cardiol 2014. [DOI: 10.1016/j.recesp.2014.08.005] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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McElhinney DB. Will there ever be a Food and Drug Administration-approved device for transcatheter paravalvular leak closure? Circ Cardiovasc Interv 2014; 7:2-5. [PMID: 24550528 DOI: 10.1161/circinterventions.114.001286] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Doff B McElhinney
- From the Departments of Pediatrics, Medicine, and Cardiothoracic Surgery, NYU Langone Medical Center, New York, NY
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