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Comparison of transcatheter and surgical treatment of paravalvular leak: Results from a 5-year follow-up study.

Authors
  • Zhang, Youjun1
  • Pan, Xin1
  • Qu, Xinkai1
  • Wang, Cheng1
  • Huang, Estella2
  • Ma, Lan1
  • Wu, Weihua1
  • Fang, Weiyi1
  • 1 Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, 241 West Huaihai Road, Shanghai, 200030, China. , (China)
  • 2 University of Illinois, 808 South Wood Street, Chicago, Illinois, 60612.
Type
Published Article
Journal
Catheterization and Cardiovascular Interventions
Publisher
Wiley (John Wiley & Sons)
Publication Date
Aug 01, 2019
Volume
94
Issue
2
Identifiers
DOI: 10.1002/ccd.27371
PMID: 29068133
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

This study aimed to compare the efficacy and safety of two different treatments of paravalvular leak (PVL). PVL is a common complication after surgical valve replacement. Re-operation is associated with high mortality, morbidity, and risk of re-leak. Catheter-based repair has emerged as a promising new therapy. Eighty-seven consecutive patients with symptomatic PVL received either transcatheter (n = 46) or surgical (n = 41) treatment at Shanghai Chest Hospital between January 2009 and December 2015.The procedural and clinical success rates were similar between the transcatheter group and the surgical group (82.6 vs. 90.2%; P = 0.30; and 69.5 vs. 73.0%; P = 0.71, respectively). There were fewer in-hospital total major adverse events in the transcatheter group (56.09 vs. 17.39%; P < 0.001), and transcatheter repair was more cost-effective, with fewer blood transfusions, shorter procedure durations, shorter hospital stays, and less expenditure. However, there were six cases of hemolysis aggravation in the transcatheter group (13.04%). The 5-year overall survival rates after transcatheter and surgical repair were 74.39 and 71.95% (P = 0.45), respectively, and the cardiac-related survival rates were 84.08 and 74.72% (P = 0.19), respectively. Transcatheter and surgical repairs are both effective treatments for selected patients with PVL. And, transcatheter closure seems to be safer and more cost-effective. Nonetheless, this new treatment may be risky for post-procedure hemolysis when unsuitable devices are used. © 2017 Wiley Periodicals, Inc.

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