Perivalvular leak

BACKGROUND: Percutaneous closure of aortic and ventricular pseudoaneurysms (PSA) has only been reported on a case report and series basis. In previous case reports, percutaneous closure has been performed successfully in patients of prohibitive surgical risk. This case series aims to show feasibility of percutaneous closure of aortic and ventricular pseudoaneurysm secondary to perivalvular leak (PVL) in a small patient population and the utility of multimodality imaging as an integral tool in procedural planning...

Transcatheter structural heart interventions are expanding into more complex spaces including mitral transcatheter edge-to-edge repair, left atrial appendage occlusion, tricuspid transcatheter edge-to-edge repair, mitral/tricuspid valve-in-valve, and perivalvular leak closures. Transesophageal echocardiography (TEE), with concomitant fluoroscopy, has remained the gold standard for many of these interventions. Although three-dimensional intracardiac echocardiography has been used, applications were often limited to guidance for more "simple" procedures such as patent foramen ovale/atrial septal defect closure and/or intraprocedural adjunctive imaging guidance...

Objective: To explore the safety and efficacy of transcatheter aortic valve replacement (TAVR) using the "All in One" single-artery/vessel technique. Methods: This is a retrospective study. A total of 30 consecutive patients underwent TAVR using the single artery/vascular technique in Beijing Anzhen Hospital from August to December 2021 were included. Baseline clinical data, operative situation, postoperative outcomes, and incidence of adverse events during hospitalization and at one month post TAVR were analyzed...

BACKGROUND: The aim of the study was to evaluate bio-functionality of a novel, proprietary balloon-expandable biological transcatheter aortic valve implantation (TAVI) system (InFlow, CardValve Consortium, Poland) in an ovine model of aortic banding. METHODS: Surgical ascending aorta banding was created in 21 sheep. Two weeks later, 18 biological valves were implanted within the model using 15-16 F InFlow TAVI systems and carotid cut-down approach. Follow-up transthoracic echocardiography was performed at 30, 90, and 180-day...

Among other valvular heart disease Aortic stenosis (AS) is the most common in the developed world. Transcatheter Aortic Valve Replacement (TAVR) is most acceptable treatment option for patient with severely calcified aortic stenosis with high and intermediate risk group. Among several challenges, one of the main challenges is to deal with bicuspid aortic valve (BAV). Non-circular annulus, bulky leaflets leading to perivalvular leaks and risk for rupture and often very severe calcification may contribute to periprocedural strokes leading to poor clinical outcome...

BACKGROUND: Data on outcomes following transcatheter aortic valve replacement with SAPIEN 3 in China is limited as it was approved by the National Medical Products since 2020. The present study was designed to collect clinical data on the SAPIEN 3 aortic valve in Chinese patients with bicuspid aortic valve and tricuspid aortic valve stenosis. METHODS: We analyzed the patient characteristics, procedural features and procedural outcomes of the first 438 patients (223 for bicuspid aortic valve and 215 tricuspid aortic valve) from 21 provinces in 74 sites treated with the SAPIEN 3 valve system for transcatheter aortic valve replacement between September 2020 and May 2022...

BACKGROUND: Mitral annular calcification (MAC) may represent a significant challenge for heart surgeons with an extremely high perioperative risk during mitral valve (MV) surgery. The risk is further increased when patients fail to be eligible for any percutaneous treatment, particularly because circumferential calcifications involving the anterior leaflet suggest a critical obstruction of the left ventricular outflow tract (LVOT). OBJECTIVES: The objective of this study was to evaluate residual mitral regurgitation (MR) after surgical mitral valve replacement using a Sapien 3 Ultra (Edwards Lifesciences, CA, USA) transcatheter aortic valve implantation (TAVI) prosthesis, reinforced with a pericardial skirt, in high-risk selected patients with severe MAC...

CASE REPORT: Ochronosis refers to the blue-black discoloration of connective tissue. While cardiovascular ochronosis has been described resulting from alkaptonuria, it may also result from chronic minocycline use which is exceedingly rare. Cardiovascular ochronosis often presents with insidious development, often identified incidentally during aortic valve replacement (AVR). Herein, we describe the case of a 71-year-old male undergoing AVR and coronary artery bypass grafting found to have minocycline-induced ochronosis of the aortic valve and aorta...

Fusion imaging is developing fast, allowing improvements in interventional cardiology procedures workup and guidance. Computed-tomography (CT) scan and fluoroscopy fusion guidance used in procedures such as left appendage occlusion or perivalvular leak closure permit prediction and simulation of the appropriatedevice, as well as implantation guidance. In the era of tailored medicine, CT/fluoroscopy fusion imaging guidance is an interesting tool for individualizing and adapting the devices implanted to each patient, as well as improving the outcomes and safety of each procedure...

Percutaneous paravalvular leak closure represents a small but important niche in structural interventions in the current era of interventional cardiology. It is estimated that paravalvular regurgitation affects 2-17% of all implanted prosthetic heart valves (which equates to 500 to 10,200 cases annually). Patients may present with clinical signs and evidence of heart failure, hemolysis or both. Due to the increased morbidity and mortality, reoperation is often best avoided, especially if the underlying perivalvular tissue is friable or heavily calcified...

INTRODUCTION: Transcatheter aortic valve implantation (TAVI) is an established alternative to aortic valve surgery in patient with severe aortic valve stenosis. As interventionalists are pushing towards treatment of patients with lower risk profile with a wide range of anatomies, contemporary transcatheter heart valves (THV) should offer an excellent performance in terms of residual gradient, rate of pacemaker and perivalvular leak. AREAS COVERED: Self-expandable (SE) valve offer a valid alternative to balloon-expandable (BE) valves, nevertheless comparative trials suggest a better outcome of patients treated with BE over SE platforms...

Objectives . The safety and effectiveness of the Trifecta GT bioprosthesis (introduced in 2016) in less invasive aortic valve replacement are scarcely investigated. Our aim was to evaluate the immediate and initial follow-up results of this device in the context of less invasive surgery. We discuss patient-specific strategies for the selection of the surgical approach. Methods. A retrospective review of 133 patients undergoing AVR with the Trifecta GT through three less invasive accesses (UMS, Upper ministernotomy; RMS, Reversed ministernotomy; RAMT, Right anterior minithoracotomy) was performed...

BACKGROUND: Although transcatheter aortic valve implantation (TAVI) is a safe and effective treatment for aortic stenosis, it still carries some risks, such as valve leaks, stroke, and even death. The left ventricular global longitudinal strain (LVGLS) measurement may be useful for the prediction of adverse events during this operation. AIM: To explore the change of LVGLS during TAVI procedure and the relationship between LVGLS and perioperative adverse events. METHODS: In this study, 61 patients who had undergone percutaneous transfemoral TAVI were evaluated by transthoracic echocardiography...

PURPOSE: To study the feasibility and outcomes of ketamine as an anesthetic adjunct during monitored anesthesia care (MAC) in transcatheter aortic valve replacement (TAVR). DESIGN: This was a retrospective study. METHODS: Data from 155 consecutive TAVR patients at a tertiary care high-volume TAVR medical center were reviewed and analyzed. FINDINGS: Among the 155 TAVR cases under MAC, intravenous ketamine was administered as an adjunct in 126 patients...

In this case illustration, a Gerbode defect in a 52-year-old woman caused by infective endocarditis was closed with autologous pericardium. Postoperative echocardiographic findings were satisfactory without residual shunt flow or perivalvular leak. Her postoperative recovery was uneventful without infection recurrence. Gerbode defect is a rare complication of infective endocarditis and careful preoperative echocardiographic work-up is imperative for successful repair.

A 58-year-old man with a history of aortic and mitral mechanical valve replacement was referred to our hospital for symptomatic chronic heart failure. In 1988, he had undergone open surgical correction of an isthmic aortic coarctation (CoA), with the creation of an extra-anatomic bypass from the left subclavian artery to the descending thoracic aorta. The following findings were found: severe mitral valve failure with perivalvular leakage, severe aortic valve stenosis, pulmonary hypertension, distal anastomotic aneurysm with the apparent occlusion of the CoA...

Objective: To investigate the feasibility, efficacy and safety of transbrachial access for interventional therapy on prosthetic paravalvular leak (PVL) post surgical valve replacement. Methods: This is a retrospective study. Patients with PVL after surgical valve replacement who underwent interventional therapy via the brachial artery approach in Structural heart disease center of Fuwai hospital between August 2017 and October 2019, were included. All patients underwent puncture of the brachial artery under local anesthesia, angiography and transcatheter closure procedure were performed...

Mitral annular calcification (MAC) represents a surgical challenge to mitral valve replacement. The presence of MAC at the time of mitral valve replacement is associated with perivalvular leak and atrial-ventricular groove injury. Although percutaneous and hybrid approaches may offer alternatives to surgical mitral valve replacement, the early and late results from these techniques remain unknown. As such, the surgical management of MAC remains relevant in the contemporary treatment of patients with MAC. Herein, we present a systematic approach to the management of MAC at the time of mitral valve replacement...

Objective: To assess the immediate and mid-term outcomes and hospital costs of patients who underwent trans-catheter closure (TC) or surgical closure (SC) of perivalvular leakage (PVL). Methods: Patients who underwent treatment of TC and SC of PVL in our center between January 2016 and December 2019 were enrolled. Baseline characteristics, procedure success, in-hospital and mid-term outcomes and hospital costs were compared. Results: A total of 141 patients were enrolled (TC, n =65 and SC, n =76). The patients in TC group were elder ((56...

INTRODUCTION: Paravalvular leak (PVL) is a common serious complication associated with prosthetic valve implantation. OBJECTIVE: The aim of this study was to report our single-center experience in a retrospective review and to analyze possible predictors of success. METHODS: We performed 33 percutaneous PVL closures in 26 patients (54% female, mean age 65±13 years). All mitral prostheses were studied previously with 3D transesophageal echocardiography (TEE), and aortic prostheses with 2D/3D TEE...