Department of Cardiovascular Medicine, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
Curr Cardiol Rep. 2018 Mar 6;20(3):18. doi: 10.1007/s11886-018-0959-x.
This review will summarize the growing importance of diagnosing and managing paravalvular leak associated with surgical and transcatheter valves.
The burden of paravalvular leak is increasing; however, advanced imaging techniques and high degree of clinical suspicion are required for diagnosis and management. The latest data from pivotal clinical trials in the field of transcatheter aortic valve replacement suggest that any paravalvular leak greater than mild was associated with worse clinical outcomes. Percutaneous techniques for paravalvular leak closure are now the preferred approach, and surgical repair is reserved for contraindications and unsuccessful procedures. Recent data from studies evaluating paravalvular leak closure outcomes report a greater than 90% success rate with a significant improvement in patient symptoms. Paravalvular leak is a growing problem in the structural heart disease arena. Percutaneous closure is successful in more than 90% of the procedures with a low complication rate.
本文将总结诊断和处理与外科及经导管瓣膜相关的瓣周漏的重要性日益增加。
瓣周漏的发生率呈上升趋势；然而，诊断和处理需要先进的影像学技术和高度的临床怀疑。经导管主动脉瓣置换术领域的关键临床试验的最新数据表明，任何瓣周漏程度大于轻度与较差的临床结局相关。经皮瓣周漏封堵技术现在是首选方法，对于有禁忌症和手术不成功的患者则保留外科修复。最近评估瓣周漏封堵结果的研究数据报告，其成功率大于 90%，患者症状有显著改善。瓣周漏是结构性心脏病领域日益严重的问题。经皮封堵成功率超过 90%，并发症发生率低。
