What question did this study set out to answer?

To evaluate and compare the clinical outcomes and procedural efficacy of transcatheter versus surgical repair for significant paravalvular leaks following valve replacement.

December 19, 2024IJC Heart & VasculatureOpen Access

Transcatheter or surgical treatment of paravalvular leaks: A meta-analysis of 13 studies and 2003 patients

View Full Paper

Ask AI

Bookmark

Why the study?

Comparative data between surgical and transcatheter paravalvular leak correction after heart valve replacement were scarce.

Does transcatheter closure reduce short-term mortality compared to surgical treatment in patients with significant paravalvular leak?

Key Points

To evaluate and compare the clinical outcomes and procedural efficacy of transcatheter versus surgical repair for significant paravalvular leaks following valve replacement.
Systematic review and meta-analysis of 13 studies including 2,003 patients treated for paravalvular leaks, predominantly involving mitral valve prostheses.
Assessed short-term all-cause mortality as the primary outcome, alongside secondary endpoints including procedural success, persistent leak, hospital stay, and long-term mortality.
Transcatheter repair significantly reduced 30-day all-cause mortality (OR 0.28, 95% CI 0.18–0.42, p < 0.001) and shortened hospital stay (mean difference -9.66 days, 95% CI -12.37 to -6.94, p < 0.001).
Persistent moderate-to-severe paravalvular leak occurred more frequently in the transcatheter cohort at 30 days (OR 3.56, 95% CI 1.49–8.49, p = 0.004) and during long-term follow-up (OR 2.20, 95% CI 1.27–3.81, p = 0.005).
Technical success, procedural success, long-term mortality, and rehospitalization rates showed no statistically significant differences between the two treatment approaches.

Structured PICO

Does transcatheter closure reduce short-term mortality compared to surgical treatment in patients with significant paravalvular leak?

Population

2003 patients with significant paravalvular leak after heart valve replacement (mostly mitral prosthesis) pooled from 13 studies

Intervention

Transcatheter closure of paravalvular leak

Comparator

Surgical treatment of paravalvular leak

Outcome

Short-term all-cause mortalityhard clinical

Transcatheter closure of paravalvular leaks is associated with lower short-term mortality and shorter hospital stays compared to surgery, but carries a higher risk of residual moderate-to-severe leak.

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

Transcatheter PVL closure may lower early mortality in high-risk patients; leaves open long-term efficacy versus surgery given higher leak persistence in observational data.

Cite This Study

Improta et al. (2024) studied this question.

synapsesocial.com/papers/6a8921f7e49c960f581ffe4b https://doi.org/10.1016/j.ijcha.2024.101583

View Full Paper

Ask AI

Bookmark

Implication

Transcatheter PVL closure may lower early mortality in high-risk patients; leaves open long-term efficacy versus surgery given higher leak persistence in observational data.

Transcatheter or surgical treatment of paravalvular leaks: A meta-analysis of 13 studies and 2003 patients

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Transcatheter or surgical treatment of paravalvular leaks: A meta-analysis of 13 studies and 2003 patients

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Also Consider