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  • Meeting abstract
  • Open Access

Surgical vs. catheter-based paravalvular mitral valve leak closure (trans apical approach). Early results. Single center experience.

  • 1,
  • 1,
  • 2,
  • 1 and
  • 1
Journal of Cardiothoracic Surgery201510 (Suppl 1) :A320

https://doi.org/10.1186/1749-8090-10-S1-A320

  • Published:

Keywords

  • Mitral Valve
  • Essential Hypertension
  • Valve Replacement
  • Mitral Valve Replacement
  • Single Center Experience

Background/Introduction

Following surgical mitral valve replacement paravalvular leaks may occur in up to 17% of patients. A significant fraction of these patients present with a symptoms of heart failure and/or anaemia. Conventional surgical closure is associated with increased morbidity and mortality. Alternative transcatheter closure has been developed and being introduced into the clinical practice with a reasonable success. More evidence is needed to compare the efficacy and safety between surgical and catheter-based paravalvular mitral valve leak closure.

Aims/Objectives

To compare efficacy and safety between two treatment methods of mitral valve paravalvular leak closure.

Method

A retrospective analysis of patients' medical records treated for mitral paravalvular leak at our institution in year 2005-2015. 41 patients had paravalvular leak closure. 31 patients had paravalvular leak repaired via conventional surgery, and 10 patients had catheter-based procedure (trans apical approach). Patients' data, operative variables, postoperative complications, 1 and 4 months postoperative results were analyzed.

Results

Patients in a catheter-based paravalvular leak closure group were older (71 ± 6 years vs. 63 ± 8 years, p = 0,004), and had higher incidence of essential hypertension (8 (80%) vs. 10 (32,3%), p = 0,008). Procedure was longer in surgical closure group (270 ± 98 min vs171 ± 86 min, p = 0,007). Early after the treatment mild/moderate regurgitation of a paravalvular leak was found more frequently in a catheter based paravalvular leak closure group (5 (50%) vs. 1 with severe regurgitation in conventional surgery group (3,45%), p = 0,0004).

Discussion/Conclusion

Catheter-based closure of a paravalvular leak is reserved for older and sicker patients. Although the procedure of catheter-based paravalvular leak closure is quicker, patients have higher incidence of mild/moderate paravalvular leak after the procedure, which has reduced over time. With more clinical experience and development of special equipment, catheter-based paravalvular leak closure could be a possible alternative to the conventional operation.

Authors’ Affiliations

(1)
Department of Cardiovascular Medicine, Vilnius University, Vilnius, LT-08661, Lithuania
(2)
Faculty of Medicine, Vilnius University, Vilnius, LT-03101, Lithuania

Copyright

© Zorinas et al. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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