Feasibility and efficacy of percutaneous closure of paravalvuar leak in patients after heart valve replacement surgery using Amplatzer vascular plug Ⅲ
10.3760/cma.j.issn.0253-3758.2019.04.006
- VernacularTitle: Amplatzer Ⅲ型血管塞治疗外科心脏瓣膜替换术后瓣周漏的可行性和有效性
- Author:
Junzhou PU
1
;
Yutong KE
2
;
Lianjun HUANG
1
;
Honglei ZHAO
3
;
Chun ZHANG
2
;
Wenhui WU
1
Author Information
1. Interventional Department, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Vascular Disease, Beijing 100029, China
2. Echocardiography Department, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Vascular Disease, Beijing 100029, China
3. Cardiac Surgery Department, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Vascular Disease, Beijing 100029, China
- Publication Type:Journal Article
- Keywords:
Heart valve diseases;
Paravalvular leak;
Vascular plug
- From:
Chinese Journal of Cardiology
2019;47(4):291-296
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the feasibility and efficacy of percutaneous closure of paravalvuar leak (PVL) in patients after heart valve replacement surgery using Amplatzer vascular plug Ⅲ (AVP Ⅲ).
Methods:In this retrospective study, consecutive PVL patients after heart valve replacement surgery receiving percutaneous closure with AVP Ⅲ in Beijing Anzhen hospital between March 2017 and October 2018 (n=21) were enrolled.The preoperative and intraoperative data and short-and mid-term outcome results were analyzed.
Results:Theage of patients in this cohort was (54.9±11.7) years, and there were 12 (57.1%) male patients. There were 8 patients (38.1%) post mitral valve replacement, 4 patients (19.0%) post aortic valve replacement and 9 patients (42.9%) post double valves replacements.There were 14 cases (66.7%) of mitral valve PVL,6 cases (28.6%) of aortic valve PVL, and 1 case (4.8%) of double valves PVL.Successful device deployment was accomplished in 18 defects from 17 PVL patients. Technical successful rate of mitral valve PVL closure and aortic valve PVL closure was 12/15 and 6/7,respectively. One patient received surgical repair due to procedure-induced femoral pseudoaneurysm.There were 17 cases of severe PVL and 1 case of moderate PVL before procedure, and there were 2 cases of moderate PVL, 6 cases mild PVL, and PVL disappeared in 10 cases after procedure (P<0.01 vs. pre-procedure). The follow-up time was (8.3±4.7) months. There were 10 cases (58.8%) of New York Heart Association (NYHA) function grade Ⅲ and 7 cases (41.2%) of NYHA function grade Ⅳ before procedure, and there were 12 cases of NYHA function grade Ⅰ(70.6%) and 5 cases (29.4%) of NYHA function grade Ⅱ post procedure (P<0.01). Post procedure, there was no displacement of the occluder and heart valve movement was not affected,and there was no new hemolysis or hemolysis worsening.
Conclusion:Percutaneous closure of PVL in patients after heart valve replacement surgery with AVP Ⅲ is feasible, and associated with favorable short-and mid-term clinical outcomes.
