Compare the safety and efficacy between transcatheter intervention and surgical closure of PVL after valve replace-ment
10.3760/cma.j.issn.1001-4497.2017.10.003
- VernacularTitle:介入封堵与外科手术治疗瓣膜置换术后瓣周漏的疗效评价
- Author:
Ping JIN
1
;
Yang LIU
;
Jiayou TANG
;
Xiuling YANG
;
Hongling LI
;
Jian YANG
;
Shiqiang YU
Author Information
1. 中国人民解放军第四军医大学西京医院心血管外科
- Keywords:
Paravalvular leakage;
Valve replacement;
Interventional occlusion;
Surgical repair
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2017;33(10):583-586
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the safety and efficacy between transcatheter intervention and surgical closure of para-valvular leakage(PVL)after valve replacement.Methods From May 2010 to May 2014,17 patients of paravalvular leakage af-ter valve replacement underwent interventional therapy and 11 patients underwent surgical closure.The perioperative charac-ters, mortality rate, complications and prognosis were compared between the patients underwent surgical procedure and tran-scatheter intervention.The average follow-up time was 13 months(1-36 months).Results The success rate of transcatheter intervention was 100%, while there were 2 in-hospital deaths in the surgical group(18%).Compared with surgical group, transcatheter intervention group has the benefit of shorter operation time[(84 ±36)min vs.(358 ±88)min](P<0.01),shor-ter hospitalization time[(11.9 ±12.1)d vs.(38.1 ±42.2)d](P<0.05), less transfusion[(1 029 ±455)ml vs.(1 438 ± 908)ml](P<0.05).There was no mechanical ventilation and ICU stay in the transcatheter intervention group.After tran-scatheter intervention, there was 7 residual shunt(47%)with an average shunt volume of(1.6 ±1.7)ml,which is remarkably reduced compared with pre-operation.In the surgical group, there was 1 case of residual shunt(9%).During the follow-up, there was no deaths in both groups, with improved heart function and no serious complications.Conclusion In the treatment of paravalvular leakage after valve replacement,transcatheter interventiontechnique has the advantages of simpler and safe ap-proach, less trauma, shorter time of hospitalization,faster post-operative recovery and lower treatment cost.This method is one of the new technology in the field of minimally invasive cardiac surgery in recent years.By improving operation skills,choosing individualized occluders and treatment of early hemolytic complications, the success rate and long-term effect of interventional therapy can get further improved.
