Hui Zhang1, Jing-Yan Wang2, Jian-Hua Lv3, Hai-Bo Hu3, Rui-Gang Xie1, Qi Jin4, Kun-Jing Pang5, Liang Xu3, Zhong-Ying Xu3, Ge-Jun Zhang3, Xiang-Bin Pan3. 1. Department of Radiology, Zhengzhou University People's Hospital, Central China Fuwai Hospital, Heart Center of Henan Provincial People's Hospital, Zhengzhou, China. 2. Department of Cardiology, Yuncheng Central Hospital, Yuncheng, China. 3. Center of Structural Heart Disease, National Center for Cardiovascular Diseases, Chinese Academic of Medical Science and Peking Union Medical College, Fuwai Hospital, Beijing, China. 4. Center for Pulmonary Vascular Diseases, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, China. 5. Department of Echocardiography, National Center for Cardiovascular Diseases, Chinese Academic of Medical Science and Peking Union Medical College, Fuwai Hospital, Beijing, China.
Abstract
Background: Transcatheter closure of paravalvular leak (PVL) has evolved into an alternative to surgery in high-risk patients. In this study, we introduce a new access for transcatheter closure of PVL and seek to evaluate the feasibility and safety of this access. Methods: We retrospectively analyzed patients undergoing transbrachial access for transcatheter mitral or aortic PVL closure (August 2017-November 2019) at our hospital. All patients underwent puncture of the brachial artery under local anesthesia. Results: The study population included 11 patients, with an average age of 55.91 ± 14.82 years. Ten out of 11 patients were successfully implanted with devices via the brachial artery approach, and one patient was converted to the transseptal approach. The technical success rate of transbrachial access was 90.9%. Mean NYHA functional class improved from 3.1 ± 0.5 before the procedure to 1.9 ± 0.5 after PVL closure. Severe paravalvular regurgitation (PVR) in five patients and moderate PVR in six patients prior to the procedure were significantly reduced to mild in four patients and none in seven patients after the procedure. Complications included one case of pseudoaneurysm and one case of moderate hemolysis aggravation after closure. One patient had an unknown cause of sudden death within 24 h after the procedure. The half-year mortality rate during follow-up was 9.1% (1/11). Conclusions: Transbrachial access for transcatheter closure of PVL may be a feasible and safe treatment and should include well-selected patients. It has several potential advantages of simplifying the procedure process and reducing postprocedural bed rest time.
Background: Transcatheter closure of paravalvular leak (PVL) has evolved into an alternative to surgery in high-risk patients. In this study, we introduce a new access for transcatheter closure of PVL and seek to evaluate the feasibility and safety of this access. Methods: We retrospectively analyzed patients undergoing transbrachial access for transcatheter mitral or aortic PVL closure (August 2017-November 2019) at our hospital. All patients underwent puncture of the brachial artery under local anesthesia. Results: The study population included 11 patients, with an average age of 55.91 ± 14.82 years. Ten out of 11 patients were successfully implanted with devices via the brachial artery approach, and one patient was converted to the transseptal approach. The technical success rate of transbrachial access was 90.9%. Mean NYHA functional class improved from 3.1 ± 0.5 before the procedure to 1.9 ± 0.5 after PVL closure. Severe paravalvular regurgitation (PVR) in five patients and moderate PVR in six patients prior to the procedure were significantly reduced to mild in four patients and none in seven patients after the procedure. Complications included one case of pseudoaneurysm and one case of moderate hemolysis aggravation after closure. One patient had an unknown cause of sudden death within 24 h after the procedure. The half-year mortality rate during follow-up was 9.1% (1/11). Conclusions: Transbrachial access for transcatheter closure of PVL may be a feasible and safe treatment and should include well-selected patients. It has several potential advantages of simplifying the procedure process and reducing postprocedural bed rest time.
Authors: Martin B Leon; Nicolo Piazza; Eugenia Nikolsky; Eugene H Blackstone; Donald E Cutlip; Arie Pieter Kappetein; Mitchell W Krucoff; Michael Mack; Roxana Mehran; Craig Miller; Marie-angéle Morel; John Petersen; Jeffrey J Popma; Johanna J M Takkenberg; Alec Vahanian; Gerrit-Anne van Es; Pascal Vranckx; John G Webb; Stephan Windecker; Patrick W Serruys Journal: J Am Coll Cardiol Date: 2011-01-07 Impact factor: 24.094
Authors: H M Omar Farouque; Jennifer A Tremmel; Farshad Raissi Shabari; Meenakshi Aggarwal; William F Fearon; Martin K C Ng; Mehrdad Rezaee; Alan C Yeung; David P Lee Journal: J Am Coll Cardiol Date: 2005-02-01 Impact factor: 24.094
Authors: William A Zoghbi; John B Chambers; Jean G Dumesnil; Elyse Foster; John S Gottdiener; Paul A Grayburn; Bijoy K Khandheria; Robert A Levine; Gerald Ross Marx; Fletcher A Miller; Satoshi Nakatani; Miguel A Quiñones; Harry Rakowski; L Leonardo Rodriguez; Madhav Swaminathan; Alan D Waggoner; Neil J Weissman; Miguel Zabalgoitia Journal: J Am Soc Echocardiogr Date: 2009-09 Impact factor: 5.251
Authors: Carlos E Ruiz; Rebecca T Hahn; Alain Berrebi; Jeffrey S Borer; Donald E Cutlip; Greg Fontana; Gino Gerosa; Reda Ibrahim; Vladimir Jelnin; Hasan Jilaihawi; E Marc Jolicoeur; Chad Kliger; Itzhak Kronzon; Jonathon Leipsic; Francesco Maisano; Xavier Millan; Patrick Nataf; Patrick T O'Gara; Philippe Pibarot; Stephen R Ramee; Charanjit S Rihal; Josep Rodes-Cabau; Paul Sorajja; Rakesh Suri; Julie A Swain; Zoltan G Turi; E Murat Tuzcu; Neil J Weissman; Jose L Zamorano; Patrick W Serruys; Martin B Leon Journal: J Am Coll Cardiol Date: 2017-04-25 Impact factor: 24.094
Authors: M Hourihan; S B Perry; V S Mandell; J F Keane; J J Rome; J A Bittl; J E Lock Journal: J Am Coll Cardiol Date: 1992-11-15 Impact factor: 24.094
Authors: Ignacio Cruz-Gonzalez; Juan Carlos Rama-Merchan; Antonio Arribas-Jimenez; Javier Rodriguez-Collado; Javier Martin-Moreiras; Manuel Cascon-Bueno; Candido Martin Luengo Journal: Rev Esp Cardiol (Engl Ed) Date: 2014-02-11
Authors: Victor G Dávila-Román; Alan D Waggoner; Elizabeth D Kennard; Richard Holubkov; W R Eric Jamieson; Lars Englberger; Thierry P Carrel; Hartzell V Schaff Journal: J Am Coll Cardiol Date: 2004-10-06 Impact factor: 24.094