Key result
Transcatheter paravalvular leak closure is linked to lower mortality versus surgery but requires more reoperations.
Why the study?
Transcatheter paravalvular leak closure has emerged as an alternative to surgery, but the extent to which it achieves short- and long-term procedural success remains controversial.
Does transcatheter paravalvular leak closure improve short- and long-term clinical outcomes compared to surgical closure in patients with paravalvular leak?
Meta-Analysis (n=1,196)
Does transcatheter paravalvular leak closure improve short- and long-term clinical outcomes compared to surgical closure in patients with paravalvular leak?
Transcatheter PVL closure offers lower mortality and shorter hospital stays compared to surgery, but at the cost of a higher reoperation rate.
Answers are grounded in this paper and cite their sources.
May favor transcatheter PVL closure for lower mortality; leaves open randomized confirmation versus surgery.
The abstract format was modified as follows: Transcatheter paravalvular leak (PVL) closure has been developed as a considered option instead of surgery. However, the extent to which this method has successfully achieved short- and long-term outcomes after the procedure is still controversial. Deeply searching the manuscript databanks, including PubMed, SCOPUS, Google Scholar, and Web of Knowledge, was planned using the relevant keywords. The two blinded reviewers reviewed the manuscript. They independently screened the titles and abstracts of the manuscripts and then deeply assessed the full texts to determine the appropriateness of inclusion. In total, 1196 procedures (552 in the percutaneous intervention groups and 644 in the surgical intervention group) were finally assessed by reviewing 8 studies. Employing a percutaneous approach led to lower early mortality and shorter hospitalization, but no difference was revealed between the percutaneous and surgical approaches in technical success rate and occurrence of 30-day stroke. Comparing the long-term outcome of transcatheter versus surgical PVL closure, the former procedure led to significantly lower long-term death, while requiring reoperation was found considerably in those who underwent transcatheter PVL closure. No difference was found in readmission due to progressing heart failure and improvement in heart failure class following the procedure. Regarding the consequences of PVL closure, using a transcatheter approach for PVL closure seems to be associated with lower mortality and shorter hospital stays; however, a significant part of the procedures with the transcatheter approach requires ultimately surgical intervention. Therefore, more studies are needed regarding the superiority of one method over another.
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Shojaeifard et al. (2025) conducted a meta-analysis in Paravalvular leak (n=1,196). Transcatheter paravalvular leak closure vs. Surgical paravalvular leak closure was evaluated on Early mortality, long-term death, and reoperation. In a meta-analysis of 1196 procedures, transcatheter paravalvular leak closure was associated with lower early and long-term mortality compared to surgery, but required more reoperations.
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