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Comparative Study
. 2016 Jul;107(1):55-62.
doi: 10.5935/abc.20160086. Epub 2016 Jun 10.

Paravalvular Regurgitation: Clinical Outcomes in Surgical and Percutaneous Treatments

[Article in English, Portuguese]
Carlos Passos Pinheiro  1 , Daniele Rezek  1 , Eduardo Paiva Costa  1 , Edvagner Sergio Leite de Carvalho  1 , Freddy Antonio Brito Moscoso  1 , Percy Richard Chavez Taborga  1 , Andreia Dias Jeronimo  1 , Alexandre Antonio Cunha Abizaid  1 , Auristela Isabel de Oliveira Ramos  1
Affiliations
Comparative Study

Paravalvular Regurgitation: Clinical Outcomes in Surgical and Percutaneous Treatments

[Article in English, Portuguese]
Carlos Passos Pinheiro et al. Arq Bras Cardiol. 2016 Jul.

Abstract

Background: Paravalvular regurgitation (paravalvular leak) is a serious and rare complication associated with valve replacement surgery. Studies have shown a 3% to 6% incidence of paravalvular regurgitation with hemodynamic repercussion. Few studies have compared surgical and percutaneous approaches for repair.

Objectives: To compare the surgical and percutaneous approaches for paravalvular regurgitation repair regarding clinical outcomes during hospitalization and one year after the procedure.

Methods: This is a retrospective, descriptive and observational study that included 35 patients with paravalvular leak, requiring repair, and followed up at the Dante Pazzanese Institute of Cardiology between January 2011 and December 2013. Patients were divided into groups according to the established treatment and followed up for 1 year after the procedure.

Results: The group submitted to percutaneous treatment was considered to be at higher risk for complications because of the older age of patients, higher prevalence of diabetes, greater number of previous valve surgeries and lower mean creatinine clearance value. During hospitalization, both groups had a large number of complications (74.3% of cases), with no statistical difference in the analyzed outcomes. After 1 year, the percutaneous group had a greater number of re-interventions (8.7% vs 20%, p = 0.57) and a higher mortality rate (0% vs. 20%, p = 0.08). A high incidence of residual mitral leak was observed after the percutaneous procedure (8.7% vs. 50%, p = 0.08).

Conclusion: Surgery is the treatment of choice for paravalvular regurgitation. The percutaneous approach can be an alternative for patients at high surgical risk.

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Conflict of interest statement

Potential Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1
Survival curve of patients undergoing regurgitation repair in the first year after the procedure.
See this image and copyright information in PMC

References

    1. Sampaio RO, Silva Jr FC, Oliveira IS, Padovesi CM, Soares JA, Silva WM, et al. Postoperative outcome of patients with prosthetic valve leak. Arq Bras Cardiol. 2009;93(3):283–289. - PubMed
    1. Smolka G, Wojakowski W. Paravalvular leak - important complication after implantation of prosthetic valve. E-Journal of Cardiology Practice. 2010;9(8)
    1. Kliger C, Eiros R, Isasti G, Einhorn B, Jelnin V, Cohen H, et al. Review of surgical prosthetic paravalvular leaks diagnosis and catheter-based closure. Eur Heart J. 2013;34(9):638–648. - PubMed
    1. O-Rourke DJ, Palac RT, Malenka DJ, Marrin CA, Arbuckle BE, Plehn JF. Outcome of mild periprosthetic regurgitation detected by intraoperative transesophageal echocardiography. J Am Coll Cardiol. 2001;38(1):163–166. - PubMed
    1. Movsovitz HD, Shah SI, Ioli A, Kotler MN, Jacobs LE. Long-term follow-up of mitral paraprosthetic regurgitation by transesophageal echocardiography. J Am Soc Echocardiogr. 1994;7(5):488–492. - PubMed

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