Key result
Percutaneous closure of paravalvular leaks has emerged as a safe and less invasive alternative to surgery, with reported technical success rates ranging from 77% to 86% and clinical success rates from 67% to 77%.
Why the study?
Does percutaneous closure of paravalvular leaks provide a safe and effective alternative to surgical re-operation in symptomatic patients?
Systematic Review
Does percutaneous closure of paravalvular leaks provide a safe and effective alternative to surgical re-operation in symptomatic patients?
Percutaneous closure of paravalvular leaks is a safe, less invasive, and effective alternative to surgical re-operation for patients presenting with heart failure or haemolytic anaemia.
Supports percutaneous closure as less-invasive option for symptomatic paravalvular leaks; confirms aggregated success in Level 1 synthesis.
Paravalvular leak (PVL) is an uncommon yet serious complication associated with the implantation of mechanical or bioprosthetic surgical valves and more recently recognized with transcatheter aortic valves implantation (TAVI). A significant number of patients will present with symptoms of congestive heart failure or haemolytic anaemia due to PVL and need further surgical or percutaneous treatment. Until recently, surgery has been the only available therapy for the treatment of clinically significant PVLs despite the significant morbidity and mortality associated with re-operation. Percutaneous treatment of PVLs has emerged as a safe and less invasive alternative, with low complication rates and high technical and clinical success rates. However, it is a complex procedure, which needs to be performed by an experienced team of interventional cardiologists and echocardiographers. This review discusses the current understanding of PVLs, including the utility of imaging techniques in PVL diagnosis and treatment, and the principles, outcomes and complications of transcatheter therapy of PVLs.
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Cruz‐González et al. (2016) conducted a systematic review in Paravalvular leak (PVL). Percutaneous closure of paravalvular leaks vs. Surgical correction or failed reduction (historical/observational) was evaluated. Percutaneous closure of paravalvular leaks has emerged as a safe and less invasive alternative to surgery, with reported technical success rates ranging from 77% to 86% and clinical success rates from 67% to 77%.
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