Two-Year Follow Up After Surgical Versus Percutaneous Paravalvular Leak Closure: A Non-Randomized Analysis

Background Percutaneous closure of paravalvular leak (PVL) has emerged as an alternative treatment. Predictors of survival and procedural success are unknown. Objectives To review our experience in the treatment of PVL and evaluate efficacy, mortality, predictors of success, and outcomes. Methods Re...

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Published in:Catheterization and cardiovascular interventions 2016-10, Vol.88 (4), p.626-634
Main Authors: Angulo-Llanos, Rocío, Sarnago-Cebada, Fernando, Rivera, Allan R., Elízaga Corrales, Jaime, Cuerpo, Gregorio, Solis, Jorge, Gutierrez-Ibañes, Enrique, Sanz-Ruiz, Ricardo, Vázquez Álvarez, ME, Fernandez-Avilés, Francisco
Format: Article
Language:English
Subjects:
Age Factors
Aged
Aged, 80 and over
Aortic Valve - diagnostic imaging
Aortic Valve - surgery
Cardiac Catheterization - adverse effects
Cardiac Catheterization - mortality
Female
Follow-Up Studies
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation - adverse effects
Heart Valve Prosthesis Implantation - instrumentation
Heart Valve Prosthesis Implantation - mortality
Hospital Mortality
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Mitral Valve - diagnostic imaging
Mitral Valve - surgery
Multivariate Analysis
Odds Ratio
paravalvular leak
Patient Readmission
percutaneous closure
Prosthesis Design
Prosthesis Failure
pulmonary hypertension
Renal Insufficiency - complications
Reoperation
Retrospective Studies
Risk Factors
Spain
Time Factors
Treatment Outcome
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Summary:Background Percutaneous closure of paravalvular leak (PVL) has emerged as an alternative treatment. Predictors of survival and procedural success are unknown. Objectives To review our experience in the treatment of PVL and evaluate efficacy, mortality, predictors of success, and outcomes. Methods Retrospective review of percutaneous PVL procedures between years 2008 and 2014. Survival and results were compared with a control cohort of surgical patients. Results Percutaneous closure was attempted in 51 patients. The surgical group had 36 patients. Defects were perimitral in 67 patients (77%). Mean follow‐up (FU) was 784.5 days. After propensity score analysis in‐hospital mortality was higher in the surgical group (30.6% vs. 9.8%, OR 6, P 0.01). Clinical improvement was higher in the percutaneous group (71.4% vs. 36.4%, P 0.002). Multivariate analysis showed normal creatinine (OR 15, P 
ISSN:1522-1946
1522-726X
DOI:10.1002/ccd.26459