Transapical closure of mitral paravalvular leaks with use of amplatzer vascular plug III.


INTRODUCTION Paravalvular leak (PVL) may complicate cardiac valve replacement surgery. Radical treatment is required if a PVL produces heart failure (HF) symptoms or severe hemolysis. Even though transcatheter PVL closure (TPVLC) has become a valid alternative to reoperation, a number of anatomical conditions may prove technically challenging for transvascular access. We intended to verify the utility of transapical access in such settings. METHODS We report a prospective series of 7 patients with mitral PVLs who underwent transapical TPVLC. The Heart Team made the choice of treatment and Amplatzer Vascular Plug III devices were used off-label as occluders. RESULTS Transapical TPVLC enabled excellent sealing of mitral PVL in 6 cases. This resulted in HF symptom reduction and decreased NT-proBNP plasma concentration. No procedure-related complications occurred. CONCLUSIONS Transapical access seems to be an efficient and safe alternative for transvascular approach for mitral TPVLC, but further technical development is still needed.

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@article{Smolka2013TransapicalCO, title={Transapical closure of mitral paravalvular leaks with use of amplatzer vascular plug III.}, author={Grzegorz A Smolka and Piotr Pysz and Marek Jasinski and Radosław Gocoł and Wojciech Domaradzki and Damian Hudziak and Marek Andrzej Deja and Andrzej Ochała and Zbigniew T Gąsior}, journal={The Journal of invasive cardiology}, year={2013}, volume={25 10}, pages={497-501} }