Key result
Percutaneous closure of mitral valve leaks with occluder devices is a viable alternative to repeat sternotomy, requiring a multi-disciplinary approach and contraindicated in active endocarditis.
Why the study?
Is percutaneous closure with occluder devices a viable alternative to re-do surgery for patients with paravalvular leak following surgical mitral valve replacement?
Is percutaneous closure with occluder devices a viable alternative to re-do surgery for patients with paravalvular leak following surgical mitral valve replacement?
Percutaneous closure offers a viable, less invasive alternative to high-risk repeat sternotomy for managing paravalvular leaks, requiring a multidisciplinary approach.
Paravalvular leak occurs in 1–5% patients following surgical valve replacement and is associated with complications including haemolysis, heart failure and endocarditis. Re-do surgery is difficult with mortality rates approaching 16%. Percutaneous closure of mitral valve leaks with occluder devices is a viable alternative to repeat sternotomy; however, clinicians should be aware of contra-indications which include active endocarditis. Management of paravalvular leak is complex and success requires multi-disciplinary approach with cardiothoracic surgeons, clinical, imaging and interventional cardiologists.
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McQuillan et al. (2016) conducted a review in Paravalvular leak post mitral valve replacement. Percutaneous closure of mitral valve leaks vs. Repeat sternotomy was evaluated. Percutaneous closure of mitral valve leaks with occluder devices is a viable alternative to repeat sternotomy, requiring a multi-disciplinary approach and contraindicated in active endocarditis.
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