Department of Structural and Congenital Heart Disease, Lenox Hill Heart and Vascular Institute, North Shore/LIJ Health System, New York, NY 10021-10075, USA.
Cardiol Clin. 2013 Aug;31(3):431-40. doi: 10.1016/j.ccl.2013.05.004.
Percutaneous paravalvular leak closure is increasingly being performed as an alternative to reoperation in patients with symptomatic prosthetic paravalvular regurgitation. This article reviews the pathogenesis of paravalvular leaks and percutaneous techniques for closure. Newer multimodality imaging techniques, including 3-dimensional (3D) transesophageal echocardiography and 3D/4D computed tomographic angiography, allow improved preprocedural planning and intraprocedural guidance. Specific techniques can be used for challenging patient anatomy and larger paravalvular leaks. Outcomes from experienced centers show acceptable rates of technical and clinical success, with lower procedural morbidity than reoperation.
经皮球囊瓣周漏封堵术在治疗症状性人工瓣周漏患者中越来越多地被用作手术修复的替代方法。本文综述了瓣周漏的发病机制和经皮封堵技术。包括三维（3D）经食管超声心动图和 3D/4D 计算机断层血管造影在内的新的多模态成像技术可改善术前规划和术中指导。针对具有挑战性的患者解剖结构和较大瓣周漏，可采用特定技术。经验丰富的中心的结果显示出可接受的技术和临床成功率，且手术相关发病率低于手术修复。
