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.
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.
Authors: Grzegorz Smolka; Piotr Pysz; Michał Kozłowski; Marek Jasiński; Radosław Gocoł; Tomasz Roleder; Agnieszka Kargul; Andrzej Ochała; Wojciech Wojakowski Journal: Postepy Kardiol Interwencyjnej Date: 2016-05-11 Impact factor: 1.426
Authors: Grzegorz Smolka; Piotr Pysz; Andrzej Ochała; Michał Kozłowski; Wojciech Zasada; Zofia Parma; Michał Tendera; Wojciech Wojakowski Journal: Arch Med Sci Date: 2016-06-13 Impact factor: 3.318
Authors: Piotr Pysz; Michał Kozłowski; Magdalena Malczewska; Eliza Adamczyk-Filipek; Wojciech Wojakowski; Grzegorz Smolka Journal: Postepy Kardiol Interwencyjnej Date: 2019-06-26 Impact factor: 1.426